J-A10012-16

J-A10013-16

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

IN THE INTEREST OF: J.W., A MINOR IN THE SUPERIOR COURT OF PENNSYLVANIA

APPEAL OF: R.W. No. 1079 WDA 2015

Appeal from the Order entered June 16, 2015 In the Court of Common Pleas of Allegheny County Family Court, at No(s): CP-02-DP-0002407-2013

IN THE INTEREST OF: J.W., A MINOR IN THE SUPERIOR COURT OF PENNSYLVANIA

APPEAL OF: R.W. No. 1446 WDA 2015

Appeal from the Order entered August 21, 2015 In the Court of Common Pleas of Allegheny County Family Court, at No(s): JV-13-2407

IN RE: J.W., A MINOR IN THE SUPERIOR COURT OF PENNSYLVANIA

APPEAL OF: J.W., BIOLOGICAL FATHER No. 1080 WDA 2015

Appeal from the Order entered June 16, 2015 In the Court of Common Pleas of Allegheny County Family Court, at No(s): DP-2407-2013 JV-13-2407

IN RE: J.W., A MINOR IN THE SUPERIOR COURT OF PENNSYLVANIA

APPEAL OF: J.W., BIOLOGICAL FATHER No. 1450 WDA 2015

Appeal from the Order entered August 21, 2015 In the Court of Common Pleas of Allegheny County Family Court, at No(s): JV-13-2407 No. DP-24 07-2013J-A10012-16

J-A10013-16

- 2 - BEFORE: GANTMAN, P.J., BENDER, P.J.E., and PANELLA, J.

MEMORANDUM BY PANELLA, J.: FILED SEPTEMBER 02, 2016

R.W. (“Mother”) and J.W. (“Father”) appeal from th e orders entered on

June 16, 2015, and August 21, 2015, with regard to their minor child, J.W.,

(“Child”), a male born in November 2013. In the Jun e 16, 2015 order, the

trial court adjudicated Child dependent pursuant to § 6302(1) of the Juvenile

Act, 42 Pa.C.S.A § 6301, et seq ., and placed him in the care of his maternal

grandmother, N.K. (“MGG”), in his own home. That or der further permitted

Mother and Father to remain in the home, with the p rovision that MGG

supervise all of their contact with the minor child and directed the parents to

have mental health evaluations. In the August 21, 2 015 order, the trial court

found that Child continues to be dependent under th e Juvenile Act and found

that, despite the parents’ substantial compliance w ith the permanency plan,

Child’s safety continues to be at risk because neit her parent has been able to

address the circumstances that led to the June 16, 2015 dependency

adjudication. The trial court further found that th e parents’ mental health

evaluation was not helpful in determining a manner in which Child will be

safe in his parents’ unsupervised care. Therefore, the trial court directed the

parents to undergo individual counseling and couple s counseling, to assist

the parents in “opening up” about the circumstances of Child’s injuries.

After careful review, we affirm both orders.J-A10012-16

J-A10013-16

- 3 - In its August 17, 2015 opinion, the trial court se t forth the following

factual background and procedural history regarding this appeal, which we

incorporate herein, as follows. 1

I. First Dependency Adjudication

This appeal is from a second adjudication of depen dency. However, the facts surrounding the first adjudicati on are relevant to the present case. On December 19, 2013, Mother took J.W. to the emergency room at Children’s Hospi tal of Pittsburgh (“Children’s Hospital”) due to unexplain ed marks that she discovered on his face and body. See Testimony of Transcript (“T.T.”), dated January 31 & February 4, 2014, at 12- 13. Mother testified that she had been at home with J.W. since Father had left for work on the morning of December 19, 2013. Id . at 229. Father returned to the home around midnig ht, from a work engagement, at which time [m]other went to sho wer as she had not been able to do so while Father was at work. Id . at 231. Following an approximate seven[-]minute shower , Mother noticed what she believed to be a red rash on J.W.’ s face. Id . at 233. After contacting J.W.’s pediatrician’s office, Mother examined the remainder of J.W.’s body and discovere d “small irregular marks on his lower abdomen.” Id . at 235. Not knowing how he obtained the “marks” on his body, Mother too k J.W. to the Children’s Hospital emergency room.

The emergency room physician contacted Dr. Jennife r Wolford, an attending physician in the Children’s H ospital Child Advocacy Center, to further examine J.W. See [ i ] d . at 9. During her examination of J.W., Dr. Wolford discovered add itional markings on J.W.’s back; she diagnosed the marks on J.W.’s back, abdomen and face as bruises that could not ha ve been self-inflicted. See T.T., dated January 31 & February 4, 2014, at 12, 19. Following Dr. Wolford's examination, J.W. h ad a skeletal survey, which initially 2 did not reveal any fractures. Id . at 18. However, a referral was subsequently made to the Of fice of Children, Youth and Families (CYF). Id . at 139.

1 We note that the trial court made an apparent cler ical error in its opinion when it stated that the appeal was from its Februar y 16, 2015 order. See Trial Court Opinion, 8/17/15 at 1.J-A10012-16

J-A10013-16

- 4 - CYF caseworker Nicholas Zdral was appointed to investigate the circumstances of J.W.’s injuries an d interviewed Dr. Wolford as well as both parents. Id . Following Mr. Zdral’s interview with the parents, CYF “decided to obtain an emergency court order to remove” J.W. from the home. Id . at 159. Following a shelter hearing on January 2, 2014, J.W . was placed with his maternal great aunt and uncle. Id

.
J.W.’s follow-up skeletal survey at Children’s Hos pital revealed a healing fracture in his right radius. 3 See T.T., dated January 31 & February 4, 2014, at 20. Dr. Wolford t estified that such an injury would have only resulted from an amo unt of force being applied to the bone and was consistent with a buse.

At the adjudicatory hearing on January 31, 2014, I found J.W. dependent due to the unexplained injuries that he sustained, which could not have happened without an adult’s knowledge. J.W. was subsequently placed in the phys ical custody of his parents; however, all contact with Mother an d Father was to be supervised. J.W.’s dependency case was ultima tely closed, and court supervision terminated, on August 8, 2014 , when Mother and Father completed all of their family ser vice plan goals.

Il. Current Dependency Adjudication

On April 25, 2015, the family returned to Children ’s Hospital due to injuries that J.W. sustained from a n alleged accidental fall in the home. See T.T., dated June 3, 2015, at 39. According to Mother, while she was carrying J.W. in her arms that morning, she missed a step and fell down the s tairs of her home. See T.T., dated June 16, 2015, at 57. Upon realizing t hat J.W. was favoring his left leg, Mother contacted th e pediatrician to schedule an appointment for J.W. later that morn ing. Id . at 58. After meeting with J.W.’s primary care physicia n, Dr. Brad Kramer, Mother and Father took J.W. to have x-rays conducted at the Cranberry Township site of UPMC Passavant. Id . at 64. After reviewing the x-ray results, Dr. Kramer infor med Mother that J.W. had fractured his right tibia and would n eed to see a pediatric orthopedic surgeon at Children’s Hospital

. Id . Upon learning that they would have to take J,W. to Child ren’s Hospital, Mother and Father demonstrated discontent with havi ng toJ-A10012-16

J-A10013-16

- 5 - return to Children’s Hospital by contacting their a ttorney, Wendy Williams, and their families, prior to actually tak ing J.W. to the hospital. Id . at 64, 93. After being convinced that taking J.W. to Children’s Hospital was in his best interest, Mothe r and Father took J.W. to meet with a pediatric orthopedic surge on. Id

.
Prior to seeing pediatric orthopedic surgeon, Dr. Timothy Ward, J.W. was first examined by the emergency room physicians. See T.T., dated June 16, 2015, at 142. Although the emergency room physician assistant recommended that J.W. receive a skeletal survey, the parents initially re fused such treatment. See T.T., dated June 3, 2015, at 39. Due to the parents’ reluctance and the nature of J.W.’s injuri es[,] the physician assistant contacted Dr. Wolford[,] who th en recommended that the skeletal survey be completed d ue to J.W.’s past injuries, and the fact that the 2014 sk eletal survey revealed J.W.’s previous right radial fracture. Id . at 40. Mother and Father did not inform the physician assistant o f J.W.’s prior injuries or the fact that J.W.’s previous right rad ial fracture, in connection with the prior dependency case, had been revealed pursuant to a skeletal survey. See T.T., dated June 16, 2015, at 149.

Following a great deal of back and forth between t he parents, their attorney and the emergency room staf f, Mother and Father ultimately agreed to the skeletal survey under the condition that they were permitted to observe the p rocedure. Id . at 65. Following the completion of the skeletal s urvey, a second fracture was revealed in J.W.’s left radius. See T.T., dated June 3, 2015, at 40. After the emergency room physicians finished treating J.W. for his two fractures, the f amily met with Dr. Ward, the pediatric orthopedic surgeon to whom Dr. Kramer had referred them. See T.T., dated June 16, 2015, at 11.

During their consult with Dr. Ward, the parents fa iled to accurately characterize J.W.’s prior involvement wi th Children’s Hospital and CYF. Id . at 11-12. Despite the fact that J.W. was previously admitted in 2013 for bruises on his face and body, the parents told Dr. Ward that J.W. was treated for a w rist fracture and implied that CYF’s involvement in the case was rather brief. Id . During the June 16, 2015 hearing, Dr. Ward testif ied that although he found J.W.’s contralateral fractures un usual, he “allowed the appearance of the family” and his shor t interactionJ-A10012-16

J-A10013-16

- 6 - with the family to “considerably” affect his opinio n. 5 Id . at 9, 11. After speaking with Dr. Wolford and receiving J.W.’ s complete medical history, Dr. Ward amended his initial medic al opinion, that J.W.’s injuries were not due to abuse. Id . at 15-16. Due to J.W.’s previously unexplained bruises, the parents’ “failure to be forthright” regarding their involvement with CYF, t he parents’ misrepresentation regarding the discovery of J.W.’s 2013 right radial fracture on the skeletal survey, and their l ack of candor to the emergency room physicians, Dr. Ward later concl uded that J.W.’s injuries were the result of abuse. Id . at 30.

On April 30, 2015, CYF received a child line repor t for J.W. See T.T., dated June 3, 2015, at 149. Following an int erview with both parents and an evaluation of their home, CYF caseworker Robert Banks filed a petition for depend ency on May 07, 2015. A two-day adjudicatory hearing was held o n June 3 and June 16, 2015 on CYF’s dependency petition, aft er which [the trial court] entered the Order that is the sub ject of this appeal.

___________________________________________________

1 Father testified that when asked about the marks o n J.W.’s body, he told Mother that he was unaware as to how J.W. came to have the marks on his face or body. See T.T., dated January 31 & February 4, 2014, at 318.

2 A subsequent skeletal survey was scheduled for Jan uary 2, 2014. Dr. Wolford testified that it is hospital pro tocol to conduct a subsequent skeletal survey as healing fractures “ show up better” than acute fractures on the x-rays. See T.T., dated January 31 & February 4, 2014, at 20.

3 Pediatric radiologist, Dr. Stefano Bartoletti, sta ted that he was able to later identify the healing fracture on the initial skeletal xrays after identifying the fracture on the subseque nt skeletal
survey x-rays. See T.T., dated January 31 & February 4, 2014, at 125, 127.

4 The parents alleged that J.W.’s injuries in connec tion with the prior adjudication were caused by hospital personne l in performing the skeletal survey. See T.T., dated January 31 & February 4, 2014, at 266-269. [The trial court] did not adopt this theory in connection with the past case.J-A10012-16

J-A10013-16

- 7 -

5 At the hearing on June 3, 2015, Dr. Wolford testif ied that the fact that J.W. had a fracture on his right leg and left arm, as a result of this accident, was "highly concerning" fo r abuse. See T.T., dated June 3, 2015, at 42

Trial Court Opinion, 8/17/15, at 1-6 (unpaginated; footnotes in original).

In the June 16, 2015 order, the trial court adjudi cated Child dependent

pursuant to the Juvenile Act and placed him in the care of MGG, in his own

home, permitting Mother and Father to remain in the home, with the

provision that MGG supervise all of their contact w ith the minor child. The

order also directed the parents to have mental heal th evaluations.

The trial court continued the factual background a nd procedural history

of the case in its opinion entered on October 30, 2 015, as follows.

On August 21, 2015, following a permanency review hearing on the above-captioned matter at which all parties were represented by counsel, [the trial court] found tha t the minor child, J.W., continues to be a Dependent Child purs uant to the Pennsylvania Juvenile Act ( See 42 Pa.C.S. §6302(1)). Despite the parents’ substantial compliance with the perman ency plan, the [trial court] found that J.W.’s safety continue s to be at risk because neither parent has been able to address the circumstances which led to the June 16, 2015 depend ency adjudication. [The trial court] further found that the mental health evaluation was not helpful in determining a manner in which J.W. will be safe in his parents' unsupervise d care. . . .

Following the adjudicatory hearing, [the trial cou rt] scheduled a permanency review hearing for August 21 , 2015, and [the trial court] ordered the parents to attend mental health evaluations to determine if there were any mental h ealth issues that they could address which would insure J.W.’s s afety. At the August 21, 2015 Permanency review hearing[,] the me ntal health evaluator, Dr. Patricia Pepe, testified that
, notwithstanding their “faking good” scores on the c hild abuseJ-A10012-16

J-A10013-16

- 8 - potential inventory, neither Mother nor Father had any mental health issues. 2 Because the mental health evaluation was not helpful in determining what was necessary for J.W. to be in his parents’ unsupervised care, [the trial court] order ed Mother and Father to enter into individual therapy, followed b y couples therapy, with the hope that either party would be m ore forthcoming once he or she is protected by confiden tiality. Thereafter, couples therapy could perhaps be more p roductive.

________________________________________________

2 Dr. Pepe also indicated that the parents told her that [the trial court] had concluded that the injury which resulted in the current dependency adjudication was “accidental.” [ The trial court] made no such finding. [The trial court] simp ly noted that the medical evidence alone (without consideration o f the history or the parents’ conduct) would not provide clear an d convincing evidence of dependency.

Trial Court Opinion, 10/30/15, at 1-2 (unpaginated; footnote omitted;

footnote in original). 2

On July 16, 2015, Mother and Father timely filed n otices of appeal,

along with concise statements, pursuant to Pa.R.A.P . 1925(a)(2)(i) from the

trial court’s June 16, 2015 order at Docket Nos. 14 46 WDA 2015 and 1450

WDA 2015, respectively. On September 21, 2015, Moth er and Father timely

filed notices of appeal, along with concise stateme nts, pursuant to Pa.R.A.P.

2 The August 21, 2015 order permitted Child to be pl aced with his parents, as long as the maternal grandparents or paternal gr andparents supervised the contact between the parents and Child. Further, the order directed that the parents would have separate counselors.J-A10012-16

J-A10013-16

- 9 - 1925(a)(2)(i) from the trial court’s August 21, 201 5 orders, at Docket Nos.

1779 and 1780, respectively. 3

Mother’s Appeals at Docket Nos. 1079 WDA 2015 and 1446 WDA 2015

In her brief on appeal, Mother raises the followin g issues.

I. Whether the trial court committed an error of la w or abused its discretion by making an adjudication of dependency with regard to the minor child, J.W., when the adjudication was not supported by clear and convincing evidence, as the trial court based its finding upon an unspecified harm that cou ld occur in the future, despite evidence showing that J.W. rece ived proper care at all times?

II. Whether the trial court committed an error of l aw or abused its discretion in finding that J.W. was without pro per parental care or control when it based its dependency upon i nformation from a past dependency case involving J.W., even th ough [Mother] was providing proper care for J.W. at the time the current action was filed?

III. Whether the trial court committed an error of law or abused its discretion by making a dependency finding based on allegations that were outside of the scope of the d ependency petition, and also where the Appellant [Mother] did not have advance notice of those allegations, in violation o f the Appellant’s [Mother’s] rights to due process and fu ndamental fairness?

IV. Whether the trial court committed an error of l aw or abused its discretion when, after a permanency hearing, it found that J.W. continued to be a dependent child solely due t o its concern that neither parent was forthcoming about J.W.’s un explained injuries in a prior dependency case, even though th e parents

3 In an order entered on October 16, 2015, this Cour t, acting sua sponte , consolidated Mother’s two appeals and Father’s two appeals, and directed that Father’s appeal be listed consecutively to Mot her’s appeals. We address both Mother’s and Father’s appeals in one Memorandu m for ease of disposition.J-A10012-16

J-A10013-16

- 10 - satisfactorily completed all of their requirements in the current case?

V. Whether the trial court committed an error of la w or abused its discretion by requiring Appellant [Mother] to p articipate in individual therapy and in couples therapy, in viola tion of Appellant [Mother’s] right to privacy?

Mother’s Brief, at 8-9.

Mother asserts that we should reverse the dependen cy finding and

disposition in the June 16, 2015 adjudication and o rder, because CYF failed

to satisfy its burden of proof by clear and convinc ing evidence. She alleges

that the trial court committed an error of law and abused discretion by not

basing its decision upon current circumstances and facts of record. Rather,

the trial court relied on information from a prior closed dependency case,

speculating that Child may not receive proper medic al care in the future,

which is contrary to the weight of the evidence. See Mother’s Brief, at 15-

16.

Mother further contends that she was deprived of d ue process and

fundamental fairness, as she did not have sufficien t notice of the allegations

that the trial court used as a basis for its decisi on. Mother states:

At issue in this case were the injuries sustained by the child when Mother fell down the stairs, while holdi ng the child, on April 25, 2015. [T]he court acknowledged that th e medical evidence on its own does not establish dependency, and the parents were never provided with any notice that a hypothetical failure to obtain medical care in the future, or J. W.’s unexplained injuries in the past, would be at issue in the curr ent proceeding. The medical experts agreed that the child could hav e sustained his injuries as a result of Mother’s fall. The tria l court thereforeJ-A10012-16

J-A10013-16

- 11 - erred in basing a finding of dependency upon the sp eculation or possibility that the child may be denied medical ca re in the future, when the facts of record established that t he child did in fact receive proper medical care. Such speculations cannot be used to justify a dependency finding, particularly when the finding required a state agency to intervene into t he privacy of family life[,] and also deprived Child’s parents of their custodial rights.

Mother’s Brief, at 16.

Mother also argues that there is no evidence, in t he record in this

case, that shows that the parents are currently inc apable of providing proper

care and control to Child, which is essential to a dependency finding. Thus,

Mother maintains that the trial court erred as a ma tter of law and abused its

discretion by making a dependency finding without c lear and convincing

evidence of each component necessary to support the finding. Accordingly,

Mother urges that this Court should reverse the Jun e 16, 2015 adjudication

and order.

Additionally, with regard to the August 21, 2015 o rder, Mother asserts

that the trial court acknowledged that the parents had completed all of the

requirements the court and CYF had imposed, which i ncluded cooperating

with CYF and participating in a psychological evalu ation. Nevertheless, the

trial court imposed a new requirement for the paren ts to attend individual

therapy and couples therapy, although the psycholog ical evaluation showed

that there were no mental health concerns. Mother c ontends that the trial

court’s position, that it could not close the curre nt dependency case until theJ-A10012-16

J-A10013-16

- 12 - parents acknowledged responsibility for Child’s inj uries, was unsupported by

statutory and case law. Moreover, Mother argues tha t a requirement to

accept responsibilities for past, unexplained injur ies should not be

determinative in a dependency action, particularly when the injuries in

question arose during a prior dependency case and w ere completely

unrelated to the injuries in the current case. Acco rdingly, Mother requests

this Court to vacate the permanency review order en tered on August 21,

2015. See Mother’s Brief, at 17-18.

Father’s appeal at Docket Nos. 1980 WDA 2015 and 14 50 WDA 2015

Father raises the following issues.

1. Was the [t]rial [c]ourt’s dependency finding aga inst the weight of the evidence given the testimony in the c ase supporting the Appellant’s [Father’s] contention th at the child’s injuries were accidentally sustained in a fall?

2. Did the [t]rial [c]ourt abuse its discretion in placing undue weight on the parents’ alleged failure to inform em ergency department staff about their son’s prior wrist frac ture and reluctance to agree to a skeletal survey?

3. Did the [t]rial [c]ourt abuse its discretion in giving undue weight to the child’s prior involvement with CYF?

4. Did the [t]rial [c]ourt abuse its discretion in finding that the parents did not take responsibility for the child’s wrist fracture?

5. Did the [t]rial [c]ourt err in making the incons istent findings that [Child] continues to be a dependent child and, at the same time, finding that the Parents have completed all t asks required of them and substantially complied with the Permane ncy Plan put into place for their family?J-A10012-16

J-A10013-16

- 13 - 6. Did the [t]rial [c]ourt err in finding that the child remains a dependent when it failed to set forth specific and attainable goals for the child’s Permanency Plan including failing t o state the likely date on which the child’s placement goals ma y be achieved?

7. Did the [t]rial [c]ourt err in ordering the Pare nts to enter into individual and couple’s therapy?

8. Did the [t]rial [c]ourt err in entering a dispos ition contrary to the child’s best interests?

Father’s Brief at Docket Nos. 1080 WDA 2015 and 145 0 WDA 2015, at 2-3.

Father asserts that Child broke his wrist and then CYF became

involved and imposed a set of goals on the parents. He further alleges that

the parents met all obligations given to them, and the case was terminated.

Father states that, in April 2015, Mother fell down the stairs while holding

Child and both Mother and Child were injured. Fathe r claims that the parents

promptly took Child to the pediatrician, then for x -rays, then to Children’s

Hospital, where staff again contacted CYF. Father a rgues that the trial

court’s findings, that the parents had not taken fu ll responsibility for Child’s

previous injury, and had “nearly” prevented Child f rom receiving necessary

medical care, are unsupported by the record.

Father states that the trial court did not find tha t one of the parents

had abused child. Nevertheless, the trial court fou nd Child dependent and

imposed multiple conditions on the parents. Father contends that the trial

court abused its discretion in making the findings and that the second

adjudication of dependency is against the weight of the evidence.J-A10012-16

J-A10013-16

- 14 - Accordingly, Father requests this Court to reverse the trial court adjudication

of dependency/disposition and permanency review ord ers entered on June

16, 2015 and August 21, 2015. See Father’s Brief, at 6.

Our standard of review in a dependency case as fol lows.

[T]he standard of review in dependency cases requir es an appellate court to accept findings of fact and cred ibility determinations of the trial court if they are suppo rted by the record, but does not require the appellate court to accept the lower court’s inferences or conclusions of law. We review for abuse of discretion[.]

In re L.Z. , 111 A.3d 1164, 1174 (Pa. 2015) (citation and quot ation marks

mitted).

The Juvenile Act defines a “dependent child” as

[a] child who:

(1) is without proper parental care or control, sub sistence, education as required by law, or other care or cont rol necessary for his physical, mental, or emotional health, or m orals. A determination that there is a lack of proper parent al care or control may be based upon evidence of conduct by th e parent, guardian or other custodian that places the health, safety or welfare of the child at risk[.]

42 Pa.C.S.A. § 6302(1).

This Court clarified the definition of “dependent child” further.

The question of whether a child is lacking proper p arental care or control so as to be a dependent child encompasses t wo discrete questions: whether the child presently is without p roper parental care and control, and if so, whether such care and control are immediately available.J-A10012-16

J-A10013-16

- 15 - In re G.T. , 845 A.2d 870, 872 (Pa. Super. 2004) (quotation ma rks and

citations omitted). See also In re J.C. , 5 A.3d 284, 289 (Pa. Super. 2010).

Additionally, we note that “[t]he burden of proof i n a dependency proceeding

is on the petitioner to demonstrate by clear and co nvincing evidence that a

child meets that statutory definition of dependency .” G.T. , 845 A.2d at 872

(citation omitted).

This Court has explained that

a court is empowered by 42 Pa.C.S. § 6341(a) and ( c) to make a finding that a child is dependent if the child me ets the statutory definition by clear and convincing eviden ce. If the court finds that the child is dependent, then the court m ay make an appropriate disposition of the child to protect the child's physical, mental and moral welfare, including allowing the ch ild to remain with the parents subject to supervision, transferri ng temporary legal custody to a relative or public agency, or tr ansferring custody to the juvenile court of another state. 42 Pa.C.S. § 6351(a).

In re D.A. , 801 A.2d 614, 617 (Pa. Super. 2002) ( en banc ).

The Juvenile Act defines “Aggravated circumstances” as including the

following circumstances:

(2) The child or another child of the parent has b een the victim of physical abuse resulting in serious bodily injur y, sexual violence or aggravated physical neglect by the pare nt.

42 Pa.C.S.A. § 6302(2).

The Juvenile Act defines “serious bodily injury” a s “bodily injury which

creates a substantial risk of death or which causes serious, permanentJ-A10012-16

J-A10013-16

- 16 - disfigurement or protracted loss or impairment of t he function of any bodily

member or organ.” 42 Pa.C.S.A. § 6302.

The Juvenile Act, in turn, defines “aggravated phy sical neglect” as,

“Any omission in the care of a child which results in a life-threatening

condition or seriously impairs the child’s function ing.” Id

.
Upon a determination that aggravated circumstances exist, the

Juvenile Act states the following.

(c.1) Aggravated circumstances.— If the county agency or the child’s attorney alleges the existence of aggra vated circumstances and the court determines that the chi ld is dependent, the court shall also determine if aggrav ated circumstances exist. If the court finds from clear and convincing evidence that aggravated circumstances exist, the c ourt shall determine whether or not reasonable efforts to prev ent or eliminate the need for removing the child from the home or to preserve and reunify the family shall be made or co ntinue to be made and schedule a hearing as required in section 6351(e)(3) (relating to disposition of dependent child).

42 Pa.C.S.A. § 6341(c.1).

Regarding the disposition of a dependent child, sub sections (e), (f),

(f.1), and (g) of § 6351 of the Juvenile Act provid es the trial court with the

criteria for its permanency plan for the subject ch ild. Pursuant to those

subsections, the trial court is to determine the di sposition that is best suited

to the safety and protection and physical, mental, and moral welfare of the

child.

The Juvenile Act further provides in pertinent part :

(e) Permanency hearings.—J-A10012-16

J-A10013-16

- 17 -

(1) [t]he court shall conduct a permanency hearing for the purpose of determining or reviewing the permane ncy plan of the child, the date by which the goal of permanency for the child might be achieved and whet her placement continues to be best suited to the safety
, protection and physical, mental and moral welfare o f the child. In any permanency hearing held with respect to the child, the court shall consult with the child regar ding the child’s permanency plan in a manner appropriate to the child's age and maturity. . . .

(2) If the county agency or the child’s attorney al leges the existence of aggravated circumstances and the c ourt determines that the child has been adjudicated dependent, the court shall then determine if aggrav ated circumstances exist. If the court finds from clear and convincing evidence that aggravated circumstances e xist, the court shall determine whether or not reasonable efforts to prevent or eliminate the need for removi ng the child from the child's parent, guardian or custodia n or to preserve and reunify the family shall be made or co ntinue to be made and schedule a hearing as provided in paragraph (3).

* * *

42 Pa.C.S.A. § 6351(e)(1)-(2).

Section 6351(f) of the Juvenile Act prescribes the pertinent inquiry for

the reviewing court:

(f) Matters to be determined at permanency hearing. -

At each permanency hearing, a court shall determin e all of the following:

(1) The continuing necessity for and appropriatenes s of the placement.J-A10012-16

J-A10013-16

- 18 -

(2) The appropriateness, feasibility and extent of compliance with the permanency plan developed for t he child.

(3) The extent of progress made toward alleviating the circumstances which necessitated the original placement.

(4) The appropriateness and feasibility of the curr ent placement goal for the child.

(5) The likely date by which the placement goal for the child might be achieved.

(5.1) Whether reasonable efforts were made to final ize the permanency plan in effect.

(6) Whether the child is safe.

(7) If the child has been placed outside the Commonwealth, whether the placement continues to be best suited to the safety, protection and physical, mental and moral welfare of the child.

* * *

(9) If the child has been in placement for at least 15 of the last 22 months or the court has determined that aggravated circumstances exist and that reasonable efforts to prevent or eliminate the need to remove the child from the child’s parent, guardian or custodia n or to preserve and reunify the family need not be made or continue to be made, whether the county agency has filed or sought to join a petition to terminate parental rights and to identify, recruit, process and approve a qua lified family to adopt the child unless:

(i) the child is being cared for by a relative best suited to the physical, mental and moral welfare of the child;

(ii) the county agency has documented a compelling reason for determining that filing aJ-A10012-16

J-A10013-16

- 19 -

petition to terminate parental rights would not serve the needs and welfare of the child; or

(iii) the child’s family has not been provided with necessary services to achieve the safe return to the child’s parent, guardian or custodian within th e time frames set forth in the permanency plan.

* * *

(f.1) Additional determination. — Based upon the determinations made under subsection (f) and all re levant evidence presented at the hearing, the court shall determine one of the following:

(1) If and when the child will be returned to the c hild’s parent, guardian or custodian in cases where the re turn of the child is best suited to the safety, protecti on and physical, mental and moral welfare of the child.

(2) If and when the child will be placed for adopti on, and the county agency will file for termination of pare ntal rights in cases where return to the child’s parent, guardian or custodian is not best suited to the saf ety, protection and physical, mental and moral welfare o f the child.

(3) If and when the child will be placed with a leg al custodian in cases where return to the child’s pare nt, guardian or custodian or being placed for adoption is not best suited to the safety, protection and physical, mental and moral welfare of the child.

(4) If and when the child will be placed with a fi t and willing relative in cases where return to the child ’s parent, guardian or custodian, being placed for adoption or being placed with a legal custodian is not best suited to the safety, protection and physical, mental and moral w elfare of the child.

(5) If and when the child will be placed in another living arrangement intended to be permanent in nature whic h is approved by the court in cases where the county age ncyJ-A10012-16

J-A10013-16

- 20 -

has documented a compelling reason that it would no t be best suited to the safety, protection and physical, mental and moral welfare of the child to be returned to th e child’s parent, guardian or custodian, to be placed for adoption, to be placed with a legal custodian or to be placed with a fit and wiling relative.

(f.2) Evidence. – Evidence of conduct by the parent that places the health, safety or welfare of the child at risk, including evidence of the use of alcohol or a controlled subs tance that places the health, safety or welfare of the child a t risk, shall be presented to the court by the county agency or any other party at any disposition or permanency hearing whether or not the conduct was the basis for the determination of depe ndency.

(g) Court order.— On the basis of the determination made under subsection (f.1), the court shall order the continu ation, modification or termination of placement or other d isposition which is best suited to the safety, protection and physical, mental and moral welfare of the child.

* * *

In its August 17, 2015 opinion, the trial court pr ovided the following

discussion of Mother’s and Father’s issues:

Mother’s and Father’s first three issues on appeal concern [the trial court’s] finding that both parents have failed to acknowledge responsibility for the child’s previous injuries that led to the February, 2014 dependency finding. There fore, it is necessary to address the issue of the previous depe ndency adjudication and the responses thereto.

At the outset[,] it must be recognized that the pr evious dependency finding in 2014 was based on the fact th at J.W. sustained injuries that could not have resulted wit hout the knowledge of an adult. Thus, while [the court] did not make the specific finding that J.W. was the victim of inflic ted abuse by an identified perpetrator, [the court] certainly found the parents to be responsible for these injuries. 6 My ruling at that time contemplated a situation where these[ ] injuries to the childJ-A10012-16

J-A10013-16

- 21 - were the result of some type of accident within the knowledge of one of the parents. This failure of the parents to take responsibility for the prior injuries became a sign ificant issue in the current adjudication, where J.W. sustained two additional fractures, as noted in the adjudicatory order of Ju ne 16, 2015.

These injuries cannot be considered in a vacuum. Appellate cases have upheld adjudications solely ba sed upon prognostic evidence. See In re E.B. , 83 A.2d 426, 433 (Pa. Super. 2013) (holding, “it is well-settled that ‘a finding of dependency can be made on the basis of prognostic e vidence and such evidence is sufficient to meet the strict burden of proof necessary to declare a child dependent.” (citing In re R.W.J. , 826 A.2d 10, 14 (Pa. Super. 2003))) [sic]. Certainl y, in this case, where this previously dependent young child h as suffered two additional fractures, the continued insistence of the parents that they are not responsible for the first inciden t establishes dependency by clear and convincing evidence. 7

Furthermore, this failure to take responsibility f or the prior injuries has had an effect on J.W.’s medical treatm ent. Upon learning from Dr. Kramer that J.W. would need to be taken to Children’s Hospital to see a pediatric orthopedic s urgeon, Mother and Father appeared to be less concerned with J.W.’ s safety and more preoccupied with whether he would be removed f rom their care. Despite just learning that their son had suff ered a tibia fracture, Mother and Father expressed their aversio n to taking the child to Children’s Hospital, only choosing to do so after being informed that it was the only place that the minor child would receive the necessary treatment for a broken bone on a Saturday. See Testimony of Transcript, (“T.T”), dated June 16, 2015, at 93.

Moreover, once arriving at Children’s Hospital, Mo ther and Father demonstrated further reluctance to have J.W. appropriately treated by initially refusing to allo w the medical staff to perform a skeletal survey. Although the 20 14 skeletal survey revealed a radial fracture of which the pare nts were unaware, both Mother and Father did not want the ho spital staff to perform a skeletal survey, as they believed it w as solely based on the prior allegations of abuse. Id . at 122. The parents’ objection to the skeletal survey demonstrates a lac k of responsibility for the safety of their son[,] and s hows thatJ-A10012-16

J-A10013-16

- 22 - Mother and Father were more worried that they “were going down the same path” and that J.W. “woul d be taken from them again.” Id . at 144, 152. Yet, were it not for the most recent skeletal survey, J.W.’s second radial fractu re would not have been discovered or treated.

The testimony of the emergency room physician, Dr. Farrell, demonstrates that Mother and Father were n ot forthcoming with information about J.W.’s previous injuries, which were relevant to his most recent treatment. A lthough both the orthopedic resident and physician’s assistant q uestioned Mother and Father regarding J.W.’s previous medical history, Mother and Father did not disclose his previous fra cture or bruises. Only after learning that the treating phy sicians wanted to complete a skeletal [scan] did Mother and Father disclose the minor child’s previous injuries. See Testimony of Transcript (“T.T.”), dated June 16, 2015, at 53. Were it not f or the information provided to Dr. Farrell by Dr. Kramer a nd Dr. Wolford, the skeletal survey, which revealed the se cond radial fracture, may not have been conducted.

Moreover, the orthopedic surgeon, Dr. Ward, testif ied that the parents’ failure to (1) provide a complete medi cal history for the minor child and (2) accurately represent CYF’s past involvement with the family caused him to premature ly conclude that J.W.’s injuries were not indicative of abuse. Dr. Ward testified that Mother and Father never informed him of the previous bruises that J.W. sustained. Additionally, Dr. Ward stated that Mother and Father implied that their pr evious involvement with CYF was “brief” and “quickly set,” which it most certainly was not. Id . at 21. Even if Mother and Father did not explicitly state that their involvement with CY F was brief, their failure to adequately characterize CYF’s invo lvement in 2014 caused Dr. Ward to prematurely render a medica l opinion that J.W.’s injuries were attributable to the accid ental falling. Although initially believing the child’s injuries t o be unusual, Dr. Ward’s medical opinion was swayed due to the incomp lete and partially inaccurate medical history that Mother an d Father provided

Therefore, it is clear that in refusing to provide both Dr. Farrell, the emergency room physician, and Dr. Ward , the orthopedic surgeon, with a complete medical and fac tual historyJ-A10012-16

J-A10013-16

- 23 - regarding J.W.’s previous injuries, Mother and Fath er demonstrated not only their inability to accept res ponsibility for the his [sic] prior injuries, as discussed supra , but also, their current inability to provide J.W. with adequate car e or control. The parents’ reluctance in cooperating with the med ical professionals at Children’s Hospital would not be s o alarming if their reluctance did not pose a danger to the child ’s physical health. [The trial court] cannot overlook the fact that Mother and Father’s lack of candor could have thwarted the ver y treatment that led to the discovery of an additional fracture

.
In the concise statements, Mother and Father mischaracterize [the trial court’s] prior adjudicat ory findings. [The court] must emphasize that the absence of a fi nding of abuse in the first dependency hearing does not in i tself establish a finding that no abuse took place. [The trial cour t’s] previous dependency finding did not hinge on whether or not Mother or Father inflicted the trauma, but on the fact that t he child sustained trauma, which the medical evidence confir med could have not have [sic] resulted without an adult’s kno wledge. The record of the February 2014 adjudicatory hearing re flects [the trial court’s] finding that a child of that age is not in a position to cause the injuries he sustained[,] and that some ad ult had knowledge of how J.W. sustained his injuries. Altho ugh [the trial court] did not identify a perpetrator or state that the minor child had been abused, [the court] did not make an altern ative finding that the trauma was not inflicted. Therefore, the p arents’ arguments that [the court] made a finding that J.W. was not abused are unsupported by the record.

The [trial court] further noted that the fact that the previous dependency case was closed after Mother an d Father met all of their goals is not indicative of the par ents’ acknowledgement of responsibility for the minor chi ld’s prior injuries. As stated in [the trial court’s] June 16, 2015 findings of fact, it is the parents’ most recent conduct with r espect to the prior incident that demonstrates their failure to a ccept responsibility for the accuracy of the prior findin g. At most, Mother’s and Father’s completion of their previous dependency goals demonstrates a propensity to cooperate with c ourt orders; it does not, however, demonstrate their acceptance of the accuracy of the prior finding, or their willingness to accept responsibility for J.W.’s prior injuries. 8J-A10012-16

J-A10013-16

- 24 -

The parents’ [next] issue on appeal avers that [the trial court] erred and abused [its] discretion in adjudic ating the child dependent where the medical evidence on its own doe s not establish dependency and there was no evidence that parent failed to obtain proper medical attention for J.W. With respect to the parents’ first argument, [the trial court] did not base [its] findings or the dependency adjudication solely on t he medical evidence. As noted, [the medical evidence] is concerning , but alone does not establish clear and convincing evide nce. What [the trial court] did find, by clear and convincing evidence, was that it became evident in this adjudication that th e parents failed to acknowledge responsibility for the prior injurie s, and[,] therefore, J.W. is at risk for medical professional s not receiving all of the information necessary to treat him and t o assess whether he is in danger. There is ample evidence in the record that Mother and Father were not candid or forthcomi ng with information regarding the child’s previous history. Multiple witnesses, including Mother and Father, testified t o the parents’ reluctance to not only have the minor child treated at Children’s Hospital, but also to submit to the skeletal survey , without which the second fracture would not have been discovered. Therefore, the parents’ arguments with respect to [this] issue on appeal should be dismissed.

___________________________________________________

6 While the parents cooperated with services and did what was asked of them by CYF, resulting in the closure of t he prior case closed [sic] after approximately eight months, it i s clear that the parents never acknowledged responsibility for the i njury.

7 As stated in [the trial court’s] adjudicatory orde r, [the trial court], as well as other professionals in this case , very well may have been influenced by the fact that the parents a ppear to be such nice, respectable people who have a nice home and plenty of resources.

8 In retrospect, the case should not have been close d without such an acknowledgement.

Trial Court Opinion, 8/17/16, at 7-12 (unpaginated; footnotes and emphasis

in original).J-A10012-16

J-A10013-16

- 25 - In the October 30, 2015 opinion, the trial court e xplained:

Both Mother and Father appeal [the] August 21, 201 5 Order of Court. 1

* * *

In their concise statements, Mother and Father bot h assert 9 matters complained of, which can be grouped into three basic issues, specifically:

1. That [the trial court] committed an error of law and an abuse of discretion in finding that J.W. continues to be dependent because parents were not forthcoming abou t what happened to this child when he was an infant, despite the parents’ substantial compliance with th e permanency plan. See Mother’s and Father’s Concise Statement of Matters, at paragraphs 1, 2, 3, 6 and 8.

2. That [the trial court] committed an error of law and an abuse of discretion in failing to set forth appropr iate goals for J.W.’s permanency plan or a likely date on whic h the permanency goals maybe achieved. See Mother’s and Father’s Concise Statement of Matters, at paragraph s 4 and 5.

3. That [the trial court] committed an error of law and an abuse of discretion in ordering the parents to atte nd both individual therapy and ultimately couples therapy, and requiring the parents’ contact with J.W. to continu e to be supervised at all times by either the paternal grandparents or maternal grandparents. See Mother’s and Father’s Concise Statement of Matters, at parag raphs 7 and 9.

Ultimately, Mother’s and Father’s issues on appeal , (which are not addressed in the Opinion in support of the adjudication) (August, 17, 2014) stem from [the trial court’s] fi nding that J.W. continues to be a dependent child despite the fact that both parents have substantially complied with the perman ency plan. However, compliance with the permanency plan does n ot equal progress. The mental health evaluations were order ed in order to assess whether a mental health issue was the rea son why theJ-A10012-16

J-A10013-16

- 26 - parents were unwilling to acknowledge their respons ibility for the injuries to the child as an infant and their result ing reluctance to cooperate with medical providers, with respect to t he recent fractures. Had the mental health evaluations reveal ed a mental health condition, which caused the parents to place the child at risk, then appropriate mental health goals could be identified so that this condition could be addressed.

Both parents deny responsibility for J.W.’s injuri es as an infant, despite [the trial court’s] finding that an adult was aware of the cause of the injuries. Instead, there appear s to be a “circling of the wagons” or a “conspiracy of silenc e.” See In Re L.Z. , 111 A.3d 1164 (Pa. 2015). Dr. Pepe’s testimony th at the parents do not have mental health issues may have r uled out one potential explanation as to why the parents hav e been unable to address the circumstances that led to the dependency adjudication.

However, without an explanation for the parents’ b ehavior, the conditions cannot be remedied[,] and J.W. canno t safely be placed in the parents [’] care without supervision. As a result, [the trial court] ordered both parents to seek individua l counseling with the hope that either Mother or Father will be forthcoming with information regarding the circumstances of J.W .’s previous injuries, so that the parents may then work towards remedying the conditions that led to the most recent dependen cy adjudication.

For the foregoing reasons, the August 21, 2015 Ord er of Court should be affirmed.

______________________________________________

1 Currently pending before the Court are Mother’s an d Father’s appeals of the June 16, 2015 dependency adjudicatio n at docket numbers at 1079 WDA 2015 and 1080 WDA 2015. As the present matter has been consolidated with the pendi ng appeals, this opinion will only address facts and issues whi ch were not addressed in the prior opinion. For more detail, se e the Trial Court Opinion, dated August 17, 2015.

Trial Court Opinion, 10/30/15, at 2-4 (footnote in original).J-A10012-16

J-A10013-16

- 27 - In In re L.Z. , our Supreme Court considered the question of whet her

this Court, sitting en banc , improperly reversed the determination of the tria l

court that the child at issue suffered child abuse, and, through the

application of the presumption of prima facie evidence of abuse set forth at

23 Pa.C.S.A. § 6381(d), that the abuse was perpetra ted by his mother.

There, a twenty-month-old male infant was brought to an emergency

room by his mother and his maternal aunt, to be tre ated for a deep cut

nearly halfway around the base of his penis. The ph ysicians at the hospital

noted bruising to the child’s cheeks, severe diaper rash, and a yeast

infection on the front of his body. Both women care d for the child together.

The physicians suspected child abuse, as the women’ s explanations for the

injuries to the child were consistent with abuse, a nd the injuries were

inconsistent with the women’s explanations. The phy sicians also suspected

that the injuries were non-accidental.

The physician who treated the child at the hospita l testified at the

dependency adjudication hearing as an expert in ped iatric medicine. When

the doctor was asked whether the dark bruising to c hild’s cheeks would

“cause a child severe pain,” she responded, “I am s ure it couldn’t have been

very comfortable.” 111 A.3d at 1168. The doctor tes tified that the injuries

(the penile laceration, cheek bruises and diaper ra sh/yeast infection) were

“consistent with a pattern of suspected child abuse ,” and that the child was a

“victim of child abuse.” Id

.J-A10012-16

J-A10013-16

- 28 - The trial court found that the child was a victim of child abuse as

defined at 23 Pa.C.S.A. § 6303, and that the mother was the perpetrator of

the abuse. See 111 A.3d at 1168-1169. The court transferred tempor ary

legal custody of the child to the county agency, an d placed the child in his

maternal grandfather’s physical custody, with his p arents receiving

supervised weekly visitation. The trial court also entered an order finding

that aggravated circumstances existed because the c hild was “the victim of

physical abuse resulting in serious bodily injury, sexual violence, or

aggravated neglect by the parent; proven as to Moth er.” Id . at at 1169.

The trial court concluded that the county agency di d not need to make

further efforts to reunify the child with his mothe r.

The mother filed an appeal to this Court. Sitting en banc , the majority

of the Court affirmed the dependency adjudication b ut vacated the abuse

determination. The dissent, authored by this jurist , and joined by Judge

Bender and then-Judge, now Justice, Wecht, took the position that the

majority improperly limited the evidentiary presump tion of § 6381(d) to find

prima facie evidence of an abuser’s identity only when the abu ser was

proven to be present at the time of the injuries. See id . at 1171.

The guardian ad litem filed an appeal with our Supreme Court, which

held that the presumption set forth in § 6381(d) wa s applicable to the case,

and that the mother offered no testimony to rebut i t. See id . at 1186. The

Court concluded that the trial court properly found that the motherJ-A10012-16

J-A10013-16

- 29 - perpetrated the abuse on the child either by inflic ting the injuries, or by

failing to protect the child from his maternal aunt . Accordingly, the Supreme

Court reversed this Court’s en banc decision, and reinstated the trial court’s

order. See id

.
The Supreme Court stated:

[C]hild abuse cases often involve a child presenti ng to a hospital with significant injuries that are entirel y consistent with common types of child abuse and entirely inconsiste nt with the implausible explanations concocted by the parents a nd responsible persons to avoid allegations of child a buse. As noted, in cases where multiple caregivers are involved, th e individuals frequently “circle the wagons” or alternatively poi nt fingers at each other. As the children may be too young or fea rful to describe the abuse, CYS agencies are left to prove their case with only the physical evidence of injuries that wo uld not ordinarily be sustained but for the action of the p arents or responsible persons and the implausible statements of the parents and responsible persons. Thus, while they c an prove the existence of abuse rather easily, they have no abil ity to assign responsibility for the heinous act among the respon sible adults. As Judge Tamilia observed in 1993, “the Legislature deemed it wise and necessary to establish a different evident iary standard” by enacting Section 6381’s(d)’s presumption to avoi d this evidentiary conundrum and protect children from fut ure abuse. [ In the Interest of J.R.W. , 631 A.2d 1019, 1023 (Pa. Super. 1993)]. . . . We emphasize that, when a child is i n the care of multiple parents or other persons responsible for c are, those individuals are accountable for the care and protec tion of the child whether they actually inflicted the injury or failed in their duty to protect the child.

Moreover, the Legislature balanced the presumption of Section 6381(d) by making it rebuttable as it merel y establishes

“ prima facie evidence” that the parent perpetrated the abuse. 23 Pa.C.S. § 6381(d). As commonly understood, prima facie evidence is “[s]uch evidence as, in the judgment of the law, is sufficient to establish a given fact, or the group or chain of facts constituting the party’s claim or defense, and whic h if notJ-A10012-16

J-A10013-16

- 30 - rebutted or contradicted, will remain sufficient.” Black’s Law Dictionary 825 (6 th ed. Abridged 1991). Accordingly, evidence that a child suffered injury that would not ordinar ily be sustained but for acts or omissions of the parent or responsi ble person is sufficient to establish that the parent or responsi ble person perpetrated that abuse unless the parent or respons ible person rebuts the presumption. The parent or responsible p erson may present evidence demonstrating that they did not in flict the abuse, potentially by testifying that they gave res ponsibility for the child to another person about whom they had no reason to fear or perhaps that the injuries were accidental r ather than abusive. The evaluation of the validity of the pres umption would then rest with the trial court evaluating the credi bility of the prima facie evidence presented by the CYS agency and the rebuttal of the parent or responsible person.

Applying Section 6381(d) as set forth above to the case at bar, we affirm the trial court’s determination that [the mother] perpetrated the abuse in the form of the laceration , the cheek bruising, and the severe diaper rash and yeast infe ction. First, because the medical evidence presented by [the agen cy] demonstrated that [the child’s] injuries were neith er accidental nor self-inflicted and because [the child] was only in the care of [his mother and aunt], the injuries were shown to b e “of such a nature as would ordinarily not be sustained or exis t except by reason of the acts or omissions of the parent or ot her person responsible for the welfare of the child[.]” 23 Pa. C.S. § 6381(d). Ergo, either [the aunt or mother] or both inflicted the abuse [the child] suffered or failed to protect him from the o ther’s abuse. [The mother] failed to rebut the presumption by pre senting evidence or testimony from her, [the aunt] or her b oyfriend establishing that [the child] was not in her care w hen the injuries were suffered and that she had no reason to questio n her decision to leave [the child] in [his aunt’s] care. Likewise, neither [the aunt] nor anyone on her behalf testifi ed. [The mother and aunt’s] self-serving claims made at the hospital were neither under oath nor subject to cross-examination . They were outside-the-record and do not constitute rebuttal e vidence. 25

Instead, ample, uncontested, unrebutted evidence e xisted for the trial court to presume that [the mother] pe rpetrated the abuse on [the child]. . . .J-A10012-16

J-A10013-16

- 31 - Additionally, the trial court did not abuse its di scretion in discrediting [the mother’s] implausible out-of-cour t explanation and instead crediting the treating doctor’s testimo nial determination that the cheek bruising was classic c hild abuse. The court found Dr. Silver credible given the patte rn of bruises showing that someone squeezed [the child’s] face be tween her thumb and fingers, bruising which could have occurr ed during the window of time [the mother] acknowledged having control of [the child] and bruising that the doctor testified would have cause [the child] severe pain. Moreover, even assum ing [the mother] did not inflict the penile laceration or th e cheek bruising, she is still responsible for [the child’s] injuries by failing to protect him from [the aunt], absent rebuttal from [ the mother] that she had no reason to fear leaving [the child] with [the aunt].

We conclude that the presumption of Section 6381(d ) is applicable to this case and that [the mother] offer ed no testimony to rebut it. Thus, the trial court proper ly found [the mother] perpetrated the abuse on [the child] either by inflicting the injuries or failing to protect [the child] from [the aunt].

__________________________________________________ __

25 Moreover, we would not fault a trial court for fail ing to credit any explanations that would have been given conside ring the implausibility of the other assertions provided at the hospital regarding [the child’s] injuries.

Id . at 1185-1186 (footnote in original; footnote omit ted).

Multiple caretaker child abuse situations are rife with credibility

determinations for the trial court, and call for th e trial court to make

credibility determinations as to the plausible and implausible explanations

for the child’s injuries. See id . at 1186 n.25.

After a careful review of the record in this matte r, we find the trial

court’s credibility findings are supported by compe tent evidence in the

record. See In re R.J.T. , 9 A.3d at 1190. We also find no deprivation ofJ-A10012-16

J-A10013-16

- 32 - Mother’s and Father’s constitutional guarantees to due process of law, for

the reasons expressed by the trial court in its opi nion, quoted above. We

find no error of law or abuse of the trial court’s discretion in ordering, in the

August 21, 2015 order, the parties to undergo indiv idual and couples

therapy, after the psychological evaluation, in ord er to reach a determination

of the identity of the perpetrator of the abuse on Child. We, therefore, find

Mother’s and Father’s appeals lack merit. According ly, we affirm the June 16,

2015 and August 21, 2015 orders of the trial court.

Orders affirmed.

Judgment Entered.

Joseph D. Seletyn, Esq. Prothonotary

Date: 9/2/2016