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NONPRECEDENTIAL DECISION SEE SUPERIOR COURT I.O.P. 65.37

IN THE INTEREST OF: J.D., A MINOR

APPEAL OF: J.C. AND G.W.

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 IN THE SUPERIOR COURT OF

 PENNSYLVANIA

 No. 1157 MDA 2019

Appeal from the Order Dated June 21, 2019

In the Court of Common Pleas of York County Juvenile Division at No(s): 

CP-67-DP-0000314-2018

BEFORE: SHOGAN, J., STABILE, J., and PELLEGRINI, J.*

MEMORANDUM BY SHOGAN, J.: FILED JANUARY 28, 2020

Appellants, J.C. and G.W., appeal from the June 21, 2019 order of the 

York County Court of Common Pleas finding that the dependent male child, 

J.D. (“Child”), born in March of 2018, was the victim of “child abuse” and that 

Appellants were the perpetrators of the abuse under the Child Protective 

Services Law (“CPSL”).1 Upon careful review, we affirm.

J.C. is the maternal grandmother of Child, G.W. is her paramour, and 

they reside together. N.T., 5/24/19, at 6.2 The record reveals that Child, 

____________________________________________

* Retired Senior Judge assigned to the Superior Court.

1 23 Pa.C.S. §§ 6301–6386.

2 Child’s mother is S.D. (“Mother”). N.T., 5/24/19, at 19. Child’s biological 

father is K.L. (“Father”). Child’s legal father is T.D. (“legal father”). Mother 

and legal father cohabited during the relevant period in this case, and Child 

resided with them. Mother, Father, and legal father are not parties to this 

appeal. Id. at 3.
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then four months old, was in the custody of Appellants in their home from 

Saturday, July 28, 2018, at 7:30 p.m., when Mother dropped him off, until 

Monday, July 30, 2018, at approximately 11:30 a.m., when Mother retrieved 

him and drove him to York Hospital Emergency Room. N.T., 5/14/19, at 1718; 

N.T., 5/24/19, at 7, 8, 21–22; N.T., 6/13/19, at 10. York Hospital transferred 

Child on that same date to Hershey Medical Center, where he was designated 

“a near fatality” due to serious head injuries. N.T., 5/14/19, at 18, 20. 

The juvenile court placed Child in the emergency custody of York County 

Office of Children, Youth & Families (“CYF”) on October 5, 2018, following the 

expiration of a safety plan for Child. On October 25, 2018, the court 

adjudicated Child dependent. During the dependency hearing, the court 

deferred presiding over CYF’s request for a finding of abuse and the identity 

of the perpetrators of that abuse because both CYF and law enforcement were 

still investigating the matter.

On February 20, 2019, CYF filed a Motion to Schedule Hearing on 

[CYF’s] Request for a Finding of Abuse. Motion, 2/20/19. CYF alleged that on 

October 29, 2018, it learned that the criminal investigation “was being closed 

with no charges being filed due to the inability to date the injuries [sustained 

by Child], and to identify a specific perpetrator.” Id. at ¶ 22. CYF alleged 

that on November 5, 2018, it submitted an indicated finding of physical abuse 

of Child, with an unnamed perpetrator of that abuse, to the Childline and 

Abuse Registry. Id. at ¶ 23. CYF alleged that it subsequently received 

additional medical records regarding Child’s injuries. Id. at ¶ 24. As a result, 
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CYF requested that the court hold an evidentiary hearing to determine whether 

Child is a victim of “child abuse” as defined in the CPSL and the identity of the 

perpetrator.

A hearing occurred across four days, on May 14, 2019, May 20, 2019, 

May 24, 2019, and June 13, 2019. On the first day of the hearing, the parties 

entered into a written stipulation regarding the authenticity and admissibility 

of CYF’s Exhibit 17, which included, in part, medical records and sixty-one

color photographs of Child taken at York Hospital. Based on the medical 

records, the parties stipulated that Child suffered the following injuries: 

a. Multiple bruises on [his] chest, lower back, right ear, 

suprapubic area;

b. Left forehead swelling and bruise;

c. Nondisplaced fracture of left parietal bone with large 

overlying scalp soft tissue hematoma;[3]

d. Acute subdural hemorrhages[4]in left frontal, 

temporoparietal, right high parietal convexity and 

interhemispheric fissure;[5]

____________________________________________

3 Gloria Lee, M.D., who examined Child when he arrived at the Hershey 

Medical Center, described this injury as “a fracture on the left side of his head 

called the parietal bone, and the swelling over the fracture. . . .” N.T., 

5/14/19, at 28.

4 Dr. Lee described “acute subdural hemorrhage” as “fresh bleeding 

between the brain and the skull.” N.T., 5/14/19, at 27.

5 Dr. Lee described “interhemispheric fissure” as “bleeding between the two 

halves of the brain.” N.T., 5/14/19, at 27.
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e. Nineteen (19) healing rib fractures; 

f. Elevated LFT’s and lipase,[6] and liver laceration.

Stipulation, 5/14/19, at 2. Moreover, the parties stipulated that these injuries 

constituted “child abuse” pursuant to Section 6303(b.1)7 and “serious bodily 

injury” pursuant to Section 6303(a).8 Id. at 3.

____________________________________________

6 As best we can discern, elevated LFTs and lipase are “liver function tests” 

that Dr. Lee described as “elevated, which suggested to us that there may 

be a liver injury. So we then ordered a CAT scan of [Child’s] abdomen, and 

this confirmed a liver laceration.” N.T., 5/14/19, at 29.

7 Section 6303 of the CPSL defines “child abuse” as follows, in relevant part.

§ 6303. Definitions.

* * * 

(b.1) Child abuse.— The term “child abuse” shall mean 

intentionally, knowingly or recklessly doing any of the following:

(1) Causing bodily injury to a child through any recent act or 

failure to act.

* * *

(8) Engaging in any of the following recent acts:

* * *

(iv) Forcefully slapping or otherwise striking a child 

under one year of age.

23 Pa.C.S. § 6303(b.1)(1), (8).

8 Section 6303 defines “serious bodily injury” as “bodily injury which creates 

a substantial risk of death or which causes serious permanent disfigurement 

or protracted loss of impairment of function of any bodily member or organ.” 

23 Pa.C.S. § 6303(a). Section 6303 defines “bodily injury” as “[i]mpairment 

of physical condition or substantial pain.” Id.
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During the hearings, CYF presented the testimony of its caseworker, 

Denise McCann, and Hershey Medical Center physician and medical expert in 

general pediatrics and child abuse pediatrics, Gloria Lee, M.D., via telephone. 

N.T., 5/20/19, at 4–79 and N.T., 5/14/19, at 15–67, respectively. Appellants 

testified on their own behalf. N.T., 5/24/19, at 4–65; N.T., 6/13/19, at 4–

101.

At the conclusion of the testimonial and documentary evidence on June 

13, 2019, the court set forth its findings of facts and conclusions of law on the 

record in open court. N.T., 6/13/19, at 114–124. The order was transcribed 

and entered on the docket on June 21, 2019. Specifically, the trial court 

found:

[T]he testimony clearly established that [J.C.] and [G.W.] were 

the joint caregivers of the minor child from 7:30 p.m. Saturday, 

July 28th, 2018, through approximately 11:00 or so Monday 

morning, July 30, 2018. The testimony established that the child 

was in no one’s care or under no one’s responsibility but for [J.C.] 

and [G.W.].

* * *

[The c]ourt believes that the evidence here today 

establishes a prima facie evidence case against [J.C.] and [G.W.]. 

That the two of them were the shared custodians and caregivers 

for [Child] between the evening of [July]

[9] 28th and late morning 

on July 30th, 2018. That they were responsible for the child’s wellbeing, welfare, and safety, and that the head injuries, based on 

the testimony of Dr. Lee, an expert acknowledged by all parties 

____________________________________________

9

 In open court and in the transcribed order, the juvenile court mistakenly 

stated “January” instead of “July.” N.T., 6/13/19, at 123; Order, 6/21/19, at 

12.
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before the [c]ourt, occurred during that time period when they 

were the sole joint caregivers of the minor child. Thus, the [c]ourt 

finds that as it relates to [Child]’s head injury,[10] he is a victim of 

child abuse and [J.C.] and [G.W.] are the perpetrators of that 

abuse.

Order, 6/21/19, at 8–9, 12.

Appellants timely filed a notice of appeal and a concise statement of 

errors complained of on appeal pursuant to Pa.R.A.P. 1925(a)(2)(i) and (b). 

On August 2, 2019, the court referenced its June 21, 2019 order in lieu of 

filing a Rule 1925(a) opinion.

On appeal, Appellants present one issue for our review:

I. Did the trial court err when it made a finding of abuse 

against Appellants where there was insufficient evidence to prove 

abuse or an omission to act where the Appellants discovered the 

injury and arranged for [Child] to get medical attention?

Appellants’ Brief at 4.

We review this appeal for an abuse of discretion. In the Interest of 

L.Z., 111 A.3d 1164, 1174 (Pa. 2015). The standard of review in dependency 

cases “requires an appellate court to accept the findings of fact and credibility 

____________________________________________

10 With respect to Child’s other injuries, the court found the evidence did not 

sufficiently narrow the timeframe of when they occurred. Order, 6/21/19, at 

6. Dr. Lee’s testimony supports the court’s finding insofar as she stated that 

Child’s injuries did not occur at the same time. N.T., 5/14/19, at 38. She 

explained that Child’s diagnostic testing revealed “callous formations” in his 

rib fractures, which is part of the healing process and normally occurs ten to 

fourteen days after fracture. Id. at 34–35, 39. In addition, Dr. Lee testified 

that, although vomiting could be a symptom of a laceration in the liver, “[i]t’s 

hard to say” when that symptom would manifest after the injury has occurred. 

Id. at 38.
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determinations of the trial court if they are supported by the record, but does 

not require the appellate court to accept the lower court’s inferences or 

conclusions of law.” Id. (citation omitted).

The identity of the perpetrator of child abuse “need only be established 

through prima facie evidence in certain situations. . . .” Interest of L.Z., 111

at 1174. 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 which if not rebutted or 

contradicted, will remain sufficient.” Id. at 1185 (citing Black’s Law Dictionary

825 (6th ed. abridged 1991)).

Section 6381(d) of the CPSL provides:

§ 6381. Evidence in court proceedings.

* * *

(d) Prima facie evidence of abuse.—Evidence that a child has 

suffered child abuse of such a nature as would ordinarily not be 

sustained or exist except by reason of the acts or omissions of the 

parent or other person responsible for the welfare of the child shall 

be prima facie evidence of child abuse by the parent or other 

person responsible for the welfare of the child.

* * *

23 Pa.C.S. § 6381(d). The L.Z. Court held:

[E]vidence that a child suffered injury that would not ordinarily be 

sustained but for the acts or omissions of the parent or responsible 

person is sufficient to establish that the parent or responsible 

person perpetrated that abuse unless the parent or responsible 

person rebuts the presumption. The parent or responsible person 

may present evidence demonstrating that they did not inflict the 

abuse, potentially by testifying that they gave responsibility for 
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the child to another person about whom they had no reason to 

fear or perhaps that the injuries were accidental rather than 

abusive. The evaluation of the validity of the presumption would 

then rest with the trial court evaluating the credibility of the prima 

facie evidence presented by the CYS agency and the rebuttal of 

the parent or responsible person.

Interest of L.Z., 111 A.3d at 1185 (footnote omitted). The Court 

emphasized, “[W]hen a child is in the care of multiple parents or other persons 

responsible for care, those individuals are accountable for the care and 

protection of the child whether they actually inflicted the injury or failed in 

their duty to protect the child.” Id. 

In this case, Appellants assert that they successfully rebutted the 

presumption that they were the perpetrators of the abuse. Specifically, 

Appellants assert:

The trial court heavily relied on the testimony of Dr. Lee when it 

made its finding of abuse regarding the head injury of the [Child]. 

While Dr. Lee’s written documentation opined that the head injury 

to the [Child] occurred within a timeframe of seventy-two (72) 

hours prior to the [Child]’s CT scan,[11]the trial court primarily 

focused on her testimony that the injury would have been 

“immediately symptomatic” and apparent to a caregiver.

In this case, Dr. Lee specified that “immediately 

symptomatic” meant that the [Child] would have been fussy, 

vomiting, lethargic, and otherwise not acting like himself. Dr. Lee 

clarified that the vomiting and other noted symptoms were 

examples of how [C]hild’s behavior would have been different. 

Testimony from Appellants clearly established that [Child] was 

fussy and not eating as he normally had when he arrived at 

Appellants’ home at 7:30 p.m., on Saturday, July 28, 2018. 

____________________________________________

11 CT scan is a “Computed Tomography” scan, also known as a CAT scan. Dr. 

Lee testified that the CT scan of Child’s head was performed at York Hospital 

on July 30, 2018. N.T., 5/14/19, at 27.
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Evidence also established that [Child] continued to be fussy 

throughout his time in Appellants’ care. However, Appellants 

reasonably attributed this fussiness in [Child] to a recent change 

in his diet to solid foods. Dr. Lee’s opinion never took this factor 

into consideration, whether the “immediate symptoms” would be 

of a different or more severe nature than those exhibited as a 

result of a recent change in a child’s diet.

Appellant’s Brief at 10–11.

Appellants testified that they babysat Child in their home overnight 

every Wednesday into Thursday and every Saturday into Sunday. N.T., 

5/24/19, at 78, 31–32; N.T., 6/13/19, at 89. Appellant J.C. testified that Child 

“had been fussy through the month of July. He had just started eating cereal 

and fruit. He was gassy. He was constipated, but other than that, he was 

perfectly fine.” N.T., 6/13/19, at 8.

J.C. testified that on the evening of Saturday, July 28, 2018, Child “had 

been very fussy . . . he appeared to be very uncomfortable.” N.T., 6/13/19, 

at 12. She noted that she “assumed that [it] was due to his diet, the change 

in his diet.”12 Id. at 13. J.C. maintained that Child’s head appeared perfectly 

normal on Saturday, July 28, 2018. Id. at 53–54. J.C. testified that Child’s 

“fussiness” continued on Sunday, July 29, 2018. Id. at 15. She stated that

on July 28 and 29, 2018, “he spit up like a regular baby, nothing that caused 

me any sort of alarm,” but he did not vomit. Id. at 16.

____________________________________________

12 There is no evidence in the record that any of Child’s “fussiness,” as 

described by Appellants, was due to a change in his diet.
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Although Child was “fussy,” J.C. explained, “I don’t believe he woke up 

in the middle of the night” on Saturday, July 28, 2018. N.T., 6/13/19, at 15. 

She explained, by that time, Child had been sleeping for six hours in the 

middle of the night when at her house. Id. at 14–15.

J.C. indicated that on Sunday, July 29, 2018, she and G.W. “were in the 

house all day” except when she went out alone at 2:00 p.m. to visit her friend 

and to pick up pizza. N.T., 6/13/19, at 15, 59–61. J.C. stated she had a habit 

of visiting her friend every time she ordered pizza because her friend lived 

next door to the pizza establishment. Id. at 60–61. J.C. testified that on the 

afternoon of July 29, 2018, she was gone for “an hour or two.” Id. at 60.

J.C. stated that after she returned home and ate the pizza, she took 

Child upstairs with her while she folded laundry, and “he proceeded to take a 

fairly long nap” on her bed, which was at approximately 5:00 p.m. on Sunday, 

July 29, 2018. N.T., 6/13/19, at 15–16. While Child was napping, Appellant 

G.W. came into the bedroom and pointed to a mark on Child’s head. Id. at 

17. J.C. did not describe which side of Child’s head bore the mark, but she 

noted the mark was “swollen outward,” which made it look like Child’s head 

“wasn’t rounded on the one side . . . .” Id. at 17–18. J.C. continued, “It 

wasn’t huge. It wasn’t alarming.” Id. at 17. J.C. stated she did not notice 

any discoloration or bruising, but she and G.W. did think it was “strange.” Id.

at 19. In addition, when she touched the swelling on Child’s head, it did not 

cause Child to “exhibit any sort of pain response.” Id. at 18.
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J.C. maintained that Child awoke from his late nap on Sunday, July 29, 

2018, between 7:30 p.m. and 8:00 p.m. N.T., 6/13/19, at 20. She went to 

bed early that night because she had to awaken at 3:00 a.m. on Monday, July 

30, 2018, to go to work. Id. at 20, 62. Therefore, J.C. testified that Appellant 

G.W. was alone with Child on Sunday night until Child fell asleep. Id. at 62.

Appellant J.C. testified that on Monday, July 30, 2018, Child “woke up 

when I woke up [at 3:00 a.m.], which was unusual . . . . Now, occasionally 

he would wake up with my alarm, but not all the time.” N.T., 6/13/19, at 20. 

She stated, “When he did wake up with my alarm, he seemed particularly 

fussy, and at that point it looked as if the swelling that we saw on his head 

had gotten much larger.” Id. at 20–21. Appellant J.C. described the size of 

the swollen area on that early morning as “between a dime and a quarter 

maybe . . ., and it was swelling outward.” Id. at 21. She testified that Child 

still did not have a pain response when she “moved [her] hand over [the 

swelling].” Id. Thereafter, J.C. made a bottle for Child, which she gave to 

G.W. to feed Child, and she left for work at approximately 4:30 a.m. Id. at 

21–22.

Similarly, G.W. testified that Child had been “fussy,” and “[t]hat was the 

reason I was bottle feeding him. Normally, he would have gotten the bottle 

and solid food. He was just acting a little off, so we didn’t want to stress him 

anymore.” N.T., 5/24/19, at 43.
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G.W. testified that on Sunday, July 29, 2018, Child “had fallen asleep in 

an awkward position for approximately two hours.” N.T., 5/24/19, at 11. 

G.W. clarified, Child “had just his head on its side.” Id. When Child awoke at 

5:00 or 6:00 p.m., Appellant G.W. noticed a swollen mark above Child’s left 

ear. Id. at 15. He stated, “I thought it was maybe a bug bite or something. 

We have cats. I wasn’t sure if maybe we had a flea or something in the house, 

something along those lines.” Id.

G.W. testified that Child went to sleep at 10:00 p.m. or 11:00 p.m. on 

Sunday, July 29, 2018, and Child awoke at 12:30 a.m. N.T., 5/24/19, at 15. 

He stated that Child “was fussy that night,” and he, not J.C., tended to Child. 

Id. at 15–16. G.W. stated that he was up with Child “a couple of times” in 

the early hours of Monday morning. Id. at 16. G.W. testified that when Child 

awoke at 3:00 a.m., “we tried giving him a bottle. [H]e really didn’t want 

that, but he ended up falling back to sleep.” Id. at 17.

G.W. noted that Child awoke for the day on Monday, July 30, 2018, at 

approximately 8:00 a.m., at which time he had diarrhea. N.T., 5/24/19, at 

17, 41. G.W. testified, “And just in the morning I noticed he had diarrhea. 

So I assumed that was why he was fussy that night [Sunday night into Monday 

morning].” Id. at 41. G.W. also noticed that the swelling remained on Child’s 

head, but he had no pain reaction to it. Id. at 17.

G.W. testified that at approximately 10:30 a.m. on Monday, July 30, 

2018, Child did react when G.W. inadvertently brushed his hand against the 
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swelling. N.T., 5/24/19, at 18, 20. G.W. described the response as “[Child] 

didn’t scream. His eyes opened up real wide, and his limbs kind of shot out.” 

Id. at 18. G.W. then became alarmed, and approximately twenty minutes 

later, after placing a bag of frozen peas on Child’s head, G.W. telephoned J.C. 

at work and asked, “[S]hould I call an ambulance, [or] take him to the doctor, 

and [J.C.] said she would call [Mother] and see what she would want to do 

with him.” Id. at 19. Appellant G.W. testified that J.C. contacted him a few 

minutes later and told him that Mother “was on her way.” Id. at 20.

With respect to Child’s head injury, the juvenile court explained, as 

follows:

Dr. Lee gave extensive testimony that supplemented and finetuned her written documentation regarding the injuries and the 

likely time frame.

While her written documentation had indicated that the 

head injury which caused the brain bleeding, brain bruising, and 

the fractured skull could have occurred perhaps up to 72 hours, 

her verbal testimony greatly narrowed that time frame in that she 

stated that the head injury would have been immediately 

noticeable to any caregiver and cause said caregiver to seek 

medical care urgently, and I’m paraphrasing, not directly quoting.

Dr. Lee’s testimony went on to say that the child would have 

been “immediately symptomatic” within a few hours maximum, 

that the scalp swelling would have been very noticeable. She went 

on to say that as a result of the head injury, there would have 

been clearly and persistently symptomatic signs that would have 

been seen by [J.C.] and [G.W.] at the time of the child being 

dropped off Saturday night at 7:30 if the injury had occurred prior 

to the mother . . . dropping the child off to [Appellants’] residence.

[Dr. Lee] was, in the [c]ourt’s opinion, crystal clear that 

given the severity of the head injuries to [C]hild, that [C]hild could 

not have gone for almost 40 hours before exhibiting the alarming 
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symptoms that [Appellants] state were not evident until midmorning on Monday, July 30th

.

Order, 6/21/19, at 6–8.

Indeed, Dr. Lee testified on direct examination as follows:

[W]e know that the brain bleeding and the skull fracture were 

clearly acute, meaning it would have happened no more . . . than 

three days [earlier]. So it could be less than two, three days 

before the CAT scan of the head imaging were taken.

Again, . . . we’re not able to distinguish whether it happened one 

to two days or two to three days, just that it could have been up 

to two to three days [before the CAT scan was performed]. . . .

N.T., 5/14/19, at 35–36. Dr. Lee continued:

Q. [By CYS counsel]: And you said specifically that as it pertains 

to the brain bleeding and the skull fracture; am I correct?

A. Correct. In addition, the head injury would have been 

immediately symptomatic and it would have been observable by 

the caregivers. So for example, [Child] would have been fussy, 

he would have not been himself, he . . . could have had vomiting, 

lethargy, and this would have prompted the caregiver to seek 

medical attention for [Child].[13]

Id. at 36. On cross-examination by J.C.’s counsel, Dr. Lee testified:

Q. This child was approximately four months old. And based on 

your experience dealing with these cases and these young 

children, are you able to see a significantly recognizable form of 

lethargy in a child that young?

A. Yes.

* * *

____________________________________________

13 Dr. Lee testified that Child’s head injury could involve some or all of the 

symptoms she described. N.T., 5/14/19, at 65–66.
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A. [A]ny caregiver would notice also. They wouldn’t be eating 

as well, they’ll be more fussy, and the scalp swelling was very 

noticeable.

Id. at 56–57.

Significantly, Dr. Lee stated, “[A]fter the head injury, it wouldn’t have 

taken long, maybe a few hours max, in which [Child] would have presented 

with vomiting, fussiness, decreased energy. So he wouldn’t have gone a few 

days with being lethargic without the caregiver knowing.” N.T., 5/14/19, at 

56. On inquiry by the juvenile court, Dr. Lee clarified:

Q. [By the court]: As to the head injury, . . . and that the 

symptoms . . . you state would have been showing within hours, 

so if [J.C.], either first noticed injuries Monday morning sometime, 

it’s your testimony based on the severity of the head injury that 

the injury would have been within hours of Monday morning, 

certainly not more than 36 hours earlier; is that correct?

A. Correct. It would have been hours or less.

Id. at 66.

Finally, it is important to note Dr. Lee’s testimony on cross-examination 

by Mother’s counsel, as follows:

Q. [By Mother’s counsel]: And did [Mother] offer any explanation 

to you as to what happened? Did she have any knowledge of what 

had happened?

A. So it started off by her saying she went to pick [Child] up from 

[J.C.]’s house that morning, and she noticed that [Child] had a 

bruise on his left forehead and some bruises on his chest and his 

abdomen, and she reported to me that [Child] was in the care of 

[J.C.] and . . . [G.W.], from Saturday, 7:00 p.m. until 11:30 a.m. 

that morning . . . .

She explained that [Child] usually stays at [J.C.’s] house 

every Saturday as well as some Wednesday evenings, and when 
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she saw these bruises, she asked [J.C.] how [Child] got the 

swelling and the bruise on his forehead. And at this time, [J.C.] 

had denied any knowledge of what happened and stated that she 

also first noticed it that morning. . . .

N.T., 5/14/19, at 48–49. In addition, Dr. Lee testified Mother told Dr. Lee 

that upon Mother’s arrival at the home of J.C. and G.W., Mother found Child 

to be “extremely tired, lethargic and not himself.” Id. at 37. Dr. Lee also 

stated that Mother reported “there was one vomiting episode [by Child] when 

she got to York Hospital.” Id.

Based on the foregoing testimonial evidence, we discern no abuse of 

discretion by the juvenile court in finding Appellants perpetrators of “child 

abuse” pursuant to the CPSL for Child’s near fatal head injuries that occurred 

while in Appellants’ sole care and custody from Saturday, July 28, 2018, at 

7:30 p.m., until Monday, July 30, 2018, at 11:30 a.m. Specifically, Dr. Lee 

explained that Child would have presented with noticeable symptoms “within 

a few hours max[imum]” of sustaining the injuries. N.T., 5/14/19, at 56.

Appellants testified that they noticed the swelling on Child’s head while 

he took a lengthy nap in an unusual position in the early evening of Sunday, 

July 29, 2018. Appellants maintained that Child slept poorly on Sunday night 

into Monday morning. J.C. testified that by 3:00 a.m. on Monday, July 30, 

2018, Child was “particularly fussy,” and his swelling was “much larger.” N.T., 

6/13/19, at 20–21. G.W. noted that by 10:30 a.m. on July 30, 2018, Child 

exhibited pain when G.W. inadvertently touched the swelled area. N.T., 

5/24/19, at 18, 20.
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Based on this evidence, we reject Appellants’ contention that Child never 

exhibited symptoms more severe than fussiness due to a change in diet. 

Indeed, Appellants testified that Child, by the early evening of Sunday, July 

29, 2018, when he had been in their sole care for nearly twenty-four hours, 

had swelling above his left ear, which worsened by 3:00 a.m. on Monday, July 

30, 2018, along with other symptoms of a disrupted sleep pattern, diarrhea, 

increased fussiness, and refused to take his bottle. By 10:30 a.m., Child 

exhibited pain when the swelling on his head was touched. Based on Dr. Lee’s 

testimony, the juvenile court did not abuse its discretion in finding that 

“[C]hild could not have gone for almost 40 hours before exhibiting the 

alarming symptoms that [Appellants] state were not evident until midmorning on Monday, July 30th.” Order, 6/21/19, at 8.

Contrary to Appellants’ contention, the record evidence demonstrates 

that Child, when four months old, suffered head injuries that “would ordinarily 

not be sustained or exist except by reason of the acts or omissions of” 

Appellants who were responsible for Child’s welfare from July 28, 2018, at 

7:30 p.m., until July 30, 2018, at approximately 11:30 a.m. See 23 Pa.C.S. 

§ 6381(d). As such, prima facie evidence exists of child abuse by Appellants. 

To the extent that Appellants attempted to rebut the presumption that they 

are the perpetrators of the “child abuse” in this case, the record supports the

court’s conclusion that they failed to do so. Accordingly, we affirm the order.

Order affirmed.
J-S60006-19

18

Judgment Entered.

Joseph D. Seletyn, Esq.

Prothonotary

Date: 01/28/2020