IN THE

ARIZONA COURT OF APPEALS

DIVISION ONE

JOELLE M., Appellant, 

v. 

DEPARTMENT OF CHILD SAFETY, L.M., Appellees. 

No. 1 CA-JV 18-0079 

Appeal from the Superior Court in Mohave County

No. S8015JD201700080 

The Honorable Douglas Camacho, Judge Pro Tempore

AFFIRMED

COUNSEL

The Stavris Law Firm PLLC, Phoenix

By Alison Stavris

Counsel for Appellant

Arizona Attorney General’s Office, Mesa

By Lauren J. Lowe

Counsel for Appellee Department of Child Safety

Mohave County Attorney’s Office, Kingman

By Bobbie Shin

Counsel for Appellee L.M.

FILED 11-6-2018
JOELLE M. v. DCS, L.M.

Opinion of the Court

2 

OPINION

Judge David D. Weinzweig delivered the decision of the Court, in which 

Presiding Judge Kenton D. Jones and Judge Peter B. Swann joined.

W E I N Z W E I G, Judge:

¶1 Joelle M. (“Mother”) appeals from the superior court’s order 

finding her daughter, L.M., dependent based upon medical neglect. 

Mother’s argument against the finding of neglect fails to account for L.M.’s 

unique needs. We hold the superior court must consider a child’s unique 

needs in a dependency action to protect the child’s best interest and 

meaningfully assess the parent’s willingness and ability to supply proper 

and effective parental care and control. Because the record supports the 

dependency finding, we affirm.

FACTS AND PROCEDURAL BACKGROUND

¶2 This is a child dependency action. Mother and Lucas M.

(“Father”) are the biological parents of L.M., who was born healthy in 

Nevada in 2011. At two months old, L.M. was rushed to the hospital with 

life-threatening brain injuries. Father was later convicted in Nevada of 

abusing his daughter and sentenced to prison.1 L.M. suffered severe and 

irreversible brain damage. She now endures dozens of chronic and 

debilitating disorders, including encephalopathy, spastic quadriplegic 

cerebral palsy and epilepsy. She requires a wheel chair and is legally blind; 

cannot feed herself or communicate, except for a few nonverbal cues; bears 

a perpetual high risk for seizures, vomiting, choking and aspiration; and 

gains nourishment from a continuous 24-hour feed delivered from a 

battery-powered feeding machine. L.M. needs full-time care and attention

for her very survival. 

¶3 Mother and L.M. later moved to Arizona. The Arizona 

Department of Child Safety (“DCS”) first learned about L.M. in July 2017, 

when she was a part-time student in a special education program for 

 

1 Father was released from prison in September 2016. The superior 

court found L.M. dependent as to Father. Father was not living with 

Mother or L.M. during the events giving rise to this dependency and his 

whereabouts are unknown.
JOELLE M. v. DCS, L.M.

Opinion of the Court

3 

“[m]edically fragile children.” The school year had just begun and DCS 

received anonymous complaints to its hotline that Mother had neglected to 

provide the school with an operational feeding machine, thus preventing 

school officials from providing L.M. with nourishment, hydration and

medication. School officials had trouble reaching Mother and it took 

several hours for her to deliver a feeding machine or power cord, even 

though she lived only minutes from the school. And when Mother did 

arrive, DCS records report that she was “usually . . . out of it” and had 

trouble “keeping her eyes open.” Mother later conceded she used 

methamphetamine “on occasion” while L.M. was at school.

¶4 The record indicates that Mother was indifferent and 

uncaring at times. School officials alerted Mother that L.M. was vomiting

uncontrollably and directed her to retrieve her daughter. Mother did not 

arrive for more than two hours after receiving the news. L.M. then returned 

to school after a brief one-week absence with a large red sore on her neck. 

The baseball-sized blotch was shiny, moist and had a strong, foul odor. 

School officials contacted Mother, who did not respond for hours. Mother 

later downplayed the blotch, even questioning whether someone had 

altered pictures of the sore to make it look worse. 

¶5 The school nurse also expressed concern about Mother’s care 

and maintenance of L.M.’s medical equipment. Mother did not provide 

clean and sterile supplies for the feeding machine, forcing the nurse to reuse 

the same tubes and bags, increasing the risk of infection. 

¶6 The matter reached a breaking point in September 2017. 

Mother again sent L.M. to school with no feeding machine and later 

delivered a feeding machine that broke down, leaving L.M. without 

nourishment for hours. School and DCS officials unsuccessfully tried to 

reach Mother. DCS took L.M. into care. 

¶7 DCS filed a dependency petition based on Mother’s failure to 

provide proper and effective parental care and control, A.R.S. § 8-

201(15)(a)(i), but continued its efforts to return L.M. to Mother’s care. 

Mother ultimately agreed to a safety plan, which provided that L.M. would 

live with her maternal grandmother and Mother until Mother passed 12 

consecutive drug tests for methamphetamine “without any missed or 

diluted samples in a month” and enrolled in counseling services to cope 

with stress. Mother breached the safety plan agreement. She failed and 

missed several drug tests for methamphetamine. 
JOELLE M. v. DCS, L.M.

Opinion of the Court

4 

¶8 The court held a dependency hearing in January 2018, where 

it heard testimony from Mother, the DCS investigator and the DCS case 

manager. It also considered testimony from an earlier Rule 51 hearing. The 

court found L.M. dependent because she had no parent willing or able to 

exercise the proper and effective parental care and control she required. 

A.R.S. § 8-201(15)(a)(i). Mother appealed. We have jurisdiction under 

Article 6, Section 9 of the Arizona Constitution, A.R.S. §§ 8-235(A), 12-

2101(A)(1) and Arizona Rule of Procedure for the Juvenile Court 103(A).

DISCUSSION

¶9 We review the superior court’s dependency order for an 

abuse of discretion, Shella H. v. Ariz. Dep’t of Child Safety, 239 Ariz. 47, 50, ¶ 

13 (App. 2016), and accept its findings of fact unless clearly erroneous, 

Michael M. v. Ariz. Dep’t of Econ. Sec., 217 Ariz. 230, 233, ¶ 10 (App. 2007). 

This court affirms a finding of dependency unless it is supported by no 

reasonable evidence. Shella H., 239 Ariz. at 50, ¶ 13. 

¶10 A dependent child includes one “[i]n need of proper and 

effective parental care and control and who has no parent or guardian 

willing to exercise or capable of exercising such care and control.” A.R.S. § 

8-201(15)(a)(i). Our primary concern is the child’s best interest. Ariz. Dep’t 

of Econ. Sec. v. Superior Court, 178 Ariz. 236, 239 (App. 1994).

¶11 Mother argues the evidence presented at the dependency 

hearing was insufficient to prove by a preponderance of the evidence that 

L.M. was dependent. See A.R.S. § 8-844(C)(1)(a)(iii) (requiring court to find 

child dependent if the allegations of the dependency petition are true by a 

preponderance of the evidence). She asserts that she “has brought the child 

to the hospital as well as medical appointments on numerous occasions.” 

¶12 We reject Mother’s argument to the extent she asserts the 

superior court should examine and decide whether a child is dependent 

based on the needs of typical children and the abilities of typical parents. 

The superior court does not use a general, unitary standard of equal 

application to all children and parents in determining whether a particular 

child is dependent. The court must instead consider the discrete and special 

needs of the particular child, both to protect the child’s best interest and 

meaningfully assess the parent’s willingness and ability to provide proper 

and effective parental care and control for that child. See A.R.S. § 8-

201(15)(a)(i). 

¶13 We are mindful that the minimal standard of parental care 

and control is far more extensive for special-needs children than for healthy 
JOELLE M. v. DCS, L.M.

Opinion of the Court

5 

children, but the statutory definition of “dependent child” frames a childspecific inquiry that turns on whether a particular child is receiving “proper

and effective parental care and control” from a parent who is “willing to 

exercise or capable of exercising such care and control.” A.R.S. § 8-

201(15)(a)(i) (emphasis added); see also A.R.S. § 8-845(B) (child-specific focus 

continues at disposition, where the court must consider “the health and 

safety of the child as a paramount concern”); Ariz. R.P. Juv. Ct. 45(B) (noting 

admissible “reports” are to address topics “appropriate to the hearing,” 

including “[t]he services provided to meet the child’s needs” and “special 

education services”). This is a variable standard, necessarily tethered to the 

child’s medical condition and individual needs. Cf. Matter of Appeal In 

Cochise Cty. Juvenile Action No. 5666-J, 133 Ariz. 157, 160 (1982) (recognizing 

in child dependency context that no “rigid definition” exists for “neglect” 

or “what is necessary” for a child’s well-being); In re Pima County, Juvenile 

Action No. J-31853, 18 Ariz. App. 219 (“The expression ‘neglect’ has no fixed 

meaning, but varies as the context of circumstances changes.”).2

¶14 On this record, we affirm the superior court’s dependency 

finding. L.M. is a special-needs child whose precarious medical condition 

demands proper and effective parental care and control. Her medical needs 

are uniquely onerous, complex and pressing. She requires round-the-clock 

medical care and relies exclusively on others to meet her basic needs. She 

requires an attentive and meticulous caregiver to guard against an everpresent slate of mortal risks, including aspiration, choking, infections and 

falls.

¶15 The court received ample evidence that Mother lacked the 

capacity and vigilance to safeguard L.M. by securing and ensuring the 

uninterrupted care and undivided attention she requires. To begin, the 

court found Mother was “currently abusing methamphetamine,” which 

was “especially concerning because of [L.M.]’s serious medical challenges.” 

Despite Mother’s assurances that methamphetamine enhanced rather than 

impaired her parental prowess, a DCS case manager testified that “parents 

under the influence of methamphetamine tend to neglect their children,” 

“forget to feed them” and “forget that they have needs.” The court

determined that Mother’s methamphetamine abuse placed L.M. at great 

peril and she was “unable to properly care for” her medically-fragile 

daughter. Given L.M.’s heightened medical needs, Mother’s substance 

 

2 Arizona courts have likewise recognized the fact-specific nature of a 

parent’s duty to provide “medical care as may be required.” No. 5666-J, 133 

Ariz. at 160 (emphasis added).
JOELLE M. v. DCS, L.M.

Opinion of the Court

6 

abuse might have satisfied the dependency standard alone, but the court 

pointed to still more evidence.

¶16 The record indicated that Mother was unreliable, 

unresponsive and careless at times. She failed to demonstrate an 

appropriate level of diligence and concern. She neglected to equip school 

officials with a feeding machine, the singular device they needed to feed, 

hydrate and medicate her daughter. She ignored or forgot about many of 

her daughter’s doctor appointments and neglected to follow up with a 

neurology specialist for several months, despite being instructed to do so. 

She also ignored warnings and occasionally fed L.M. orally, despite a high 

risk of aspiration and choking, which the court described as evidence of 

Mother “choosing to do things the way she want[ed] to even if advised not 

to do it by medical providers.” She failed to notice and then minimized a 

foul-smelling, baseball-sized red sore on L.M.’s neck. She also neglected to 

maintain L.M.’s medical equipment, increasing the risk of infection.

¶17 Nor did Mother spring into action when informed that L.M. 

was ill or needed a feeding machine. She instead waited hours to tackle 

these emergencies, leaving L.M. without basic nourishment and parental 

care for extended periods. School officials, a nurse and DCS witnesses 

explained that Mother was hard to reach. She did not answer her phone 

and her voicemail was too full to accept additional messages. The school 

nurse opined that L.M. was harmed by Mother’s unresponsiveness.

¶18 We are unpersuaded by Mother’s attempt to direct us to more 

favorable evidence for her position. She asks us to reweigh the evidence 

presented to the superior court, ignoring or discounting the weight of 

adverse evidence, which we will not do. Jesus M. v. Ariz. Dep’t Econ. Sec., 

203 Ariz. 278, 282, ¶ 12 (App. 2002). We defer to the superior court, which 

heard and weighed the evidence, observed the parties and witnesses, 

gauged credibility and resolved questions of fact. Jennifer S. v. Dep’t of Child 

Safety, 240 Ariz. 282, 286-87, ¶ 16 (App. 2016). 

¶19 In sum, L.M. depends upon a heightened level of 

uninterrupted care for her very survival, but Mother has proven unwilling 

or unable to grasp the complexities and demands of caring for her daughter. 

L.M. is thus dependent as to Mother.
JOELLE M. v. DCS, L.M.

Opinion of the Court

7 

CONCLUSION

¶20 We affirm the superior court’s dependency finding.