NOTICE: NOT FOR OFFICIAL PUBLICATION.

UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL

AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.

IN THE

ARIZONA COURT OF APPEALS

DIVISION ONE

MARSHA M., Appellant, 

v.

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

No. 1 CA-JV 18-0237 

Appeal from the Superior Court in Maricopa County

No. JD527147 

 JS518572 

The Honorable Arthur T. Anderson, Judge

AFFIRMED

COUNSEL

Maricopa County Public Advocate, Mesa

By David C. Lieb

Counsel for Appellant 

Arizona Attorney General’s Office, Mesa

By Amanda Adams 

Counsel for Appellee Department of Child Safety

FILED 3-19-2019
MARSHA M. v. DCS, et al.

Decision of the Court

2 

MEMORANDUM DECISION

Judge Jennifer M. Perkins delivered the decision of the Court, in which 

Presiding Judge David D. Weinzweig and Judge Kent E. Cattani joined.

P E R K I N S, Judge:

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

terminating her parental rights to her two children. For the following 

reasons, we affirm. 

FACTUAL AND PROCEDURAL BACKGROUND

¶2 Mother suffers from bipolar and anxiety disorders. In 

September 2013, Mother tested positive for methadone, opiates, and 

benzodiazepines at L.M.’s birth. The Department of Child Safety (“DCS”) 

took custody of L.M. and petitioned the superior court for a dependency 

finding. The court eventually found L.M. dependent and set a case plan of 

family reunification. Over the next four and a half years, DCS referred 

Mother for services, including substance-abuse testing and treatment, three

psychological evaluations, a bonding assessment, counseling, three parentaide referrals, and visitation. Mother also obtained mental-health services 

through Lifewell. 

¶3 Mother initially struggled with addressing her mental health

and with parenting L.M. In March 2014, Mother was hospitalized for 

fourteen days for displaying paranoia and delusions. The next month, 

Mother completed her first psychological evaluation with Dr. James Thal. 

He gave Mother a guarded prognosis of her ability to parent L.M. in the 

future and recommended that she attend individual therapy. Accordingly, 

she attended some counseling after October 2014. 

¶4 Meanwhile, Mother successfully completed her first parentaide service. The parent aide expressed concern, however, because Mother 

appeared lethargic and unfocused at some visits. The parent aide suggested 

DCS assign a safety monitor if Mother regained custody of L.M.

¶5 DCS then referred Mother for a visitation-only parent aide.

Visits took place at an apartment Mother shared with Oliver A. (“Father”). 

The juvenile court would later terminate Father’s parental rights. On 

appeal, Father’s counsel filed a notice stating he could not find any nonfrivolous issue and we subsequently dismissed Father’s appeal. See Ariz. 
MARSHA M. v. DCS, et al.

Decision of the Court

3 

R.P. Juv. Ct. 106(G). The first parent aide reported that Mother appeared 

tired and “dazed” and would often watch TV rather than interact with the 

children. She also noted that Mother failed to redirect L.M. when she would 

get into Mother’s medications and various trinkets in the home. The parent 

aide also expressed concern with Mother’s ability to independently parent 

L.M.

¶6 In May 2015, the superior court changed the case plan to 

termination and adoption and DCS moved to terminate Mother’s parental 

rights on the grounds of substance abuse and fifteen months’ time in care. 

One month later, Mother gave birth to C.M. and DCS took custody of him.

C.M. was born substance exposed; Mother struggled with an addiction to 

prescription pills until August 2015, but thereafter completed a treatment 

program and maintained sobriety through the termination hearing.

¶7 In August 2015, Mother completed a second psychological 

evaluation with Thal. Thal reported that Mother had “made relatively little 

progress since her previous evaluation.” He gave Mother a poor prognosis 

of being able to parent her children in the foreseeable future, and he 

concluded that her “drug addictions and bipolar disorder [render her] 

incapable of providing safe and effective care to a child.” He also noted that 

any child in her care would be at a substantial risk for neglect and “could 

be exposed to frightening levels of emotional instability.”

¶8 In June 2016, Mother completed a third psychological 

evaluation; this time with Dr. Joseph Bluth. Bluth confirmed Mother’s 

bipolar disorder and further diagnosed her with an unspecified personality 

disorder with antisocial and dependent traits. Bluth gave Mother a poor 

prognosis for parenting the children in the foreseeable future. He 

concluded a child in her care would be at risk for neglect and recommended 

“alternative permanency plans.”

¶9 That same month, Bluth also performed a bonding and best 

interests assessment between Mother and L.M. Bluth determined that they 

shared a bond, but it was not a strong one, and recommended termination

and adoption for L.M. Meanwhile, Mother successfully completed her 

second full parent-aide service. That parent aide was concerned, however,

about Mother’s ability to independently parent the children and 

recommended that visits remain supervised.

¶10 In April 2017, Mother moved into her own apartment. 

Around this same time, Mother enrolled in counseling through Lifewell. 

DCS amended its termination motion regarding L.M. to include the mentalillness ground. It later moved to terminate Mother’s parental rights to C.M. 
MARSHA M. v. DCS, et al.

Decision of the Court

4 

under the grounds of fifteen months’ time in care and inability to parent 

due to mental illness.

¶11 In May 2017, Mother moved to have DCS return the children 

to her under Arizona Rule of Procedure for the Juvenile Court 59. At the 

ensuing hearing, DCS agreed that Mother had engaged in services, but 

opposed her motion because she had still not demonstrated that she could 

provide appropriate supervision or meet the children’s special needs. For 

example, L.M. displayed anxiety and sexualized behaviors and was

diagnosed with post-traumatic stress disorder. C.M. has multiple medical 

diagnoses, is developmentally delayed, and requires weekly therapy and a 

very restrictive diet. To this point, Mother had attended very few of the 

children’s numerous medical or therapy appointments, or the child and 

family team (“CFT”) meetings. Even when she did attend CFT meetings, 

she struggled to recall or understand medical diagnoses or instructions 

given to her.

¶12 Ultimately, Mother withdrew her motion, and the court 

continued the termination hearing to allow Mother more time to 

demonstrate whether she could safely parent the children and meet their 

needs on her own. After that, Mother attended many of the children’s 

appointments and CFT meetings. Upon court order, DCS also provided 

Mother with a third parent aide. This parent aide reported that Mother 

failed to redirect the children in hazardous situations, such as attempting 

to eat a glow stick, touching a hot stove, or microwaving a metal lunch box.

¶13 The superior court held a contested termination hearing over 

three days in February and two days in March, 2018. The court eventually 

terminated Mother’s parental rights to both children under grounds of 

inability to parent due to mental illness and fifteen months’ out-of-home 

placement, but found that DCS failed to prove the substance abuse ground.

The court also found termination would be in the children’s best interests 

because Mother was unable to meet their special health, developmental, 

and emotional needs. Mother timely appealed the court’s order.

DISCUSSION

¶14 Mother asserts that the court erred in finding DCS made 

diligent efforts to provide her with appropriate reunification services as 

required under the fifteen months’ time-in-care ground. A.R.S. § 8-

533(B)(8). She specifically argues that DCS failed to provide her with 

specialized instruction on the children’s medical and behavioral needs or

opportunities to demonstrate that she could manage those needs. Because 
MARSHA M. v. DCS, et al.

Decision of the Court

5 

reasonable evidence supports the court’s finding, we affirm the termination 

order. 

¶15 We will not reverse the juvenile court’s termination order 

“unless no reasonable evidence supports its factual findings.” Jennifer S. v. 

Dep’t of Child Safety, 240 Ariz. 282, 287, ¶ 16 (App. 2016). The juvenile court 

sits as the trier of fact, and this Court views the evidence and reasonable 

inferences drawn from it in the light most favorable to sustaining the 

juvenile court’s decision; we will not reweigh the evidence. Jordan C. v. Ariz. 

Dep’t of Econ. Sec., 223 Ariz. 86, 93, ¶ 18 (App. 2009). To terminate parental 

rights, the juvenile court must find at least one statutory ground under 

A.R.S. § 8-533 by clear and convincing evidence, A.R.S. § 8-537(B), and that 

termination is in a child’s best interests by a preponderance of evidence, 

Kent K. v. Bobby M., 210 Ariz. 279, 288, ¶ 41 (2005). 

¶16 When seeking termination under the fifteen-month out-ofhome placement ground, DCS must prove that it “made a diligent effort to 

provide appropriate reunification services” to the parent. A.R.S. § 8-

533(B)(8). DCS must show that it provided the parent with “the time and 

opportunity to participate in programs designed to help her become an 

effective parent.” In re Maricopa Cty. Juv. Action No. JS-501904, 180 Ariz. 348, 

353 (App. 1994). DCS need not “provide every conceivable service or . . . 

ensure that a parent participates in each service it offers.” Id.

¶17 Mother did not raise concerns over the adequacy of services

until June 2017—almost four years after L.M.’s birth and two years after 

C.M.’s birth. She struggled with drug addiction and with stabilizing her 

mental health until about August 2015. Thereafter, to her credit, Mother 

established sobriety and regularly participated in services. Even so,

through May 2017, Mother did not take advantage of the many 

opportunities she had to learn about her children’s special needs. The case 

manager explained that “those skills [could] only be learned during 

doctors’ appointments and CFTs,” both of which Mother barely attended.

¶18 Through May 2017, she failed to attend most of the children’s 

medical and behavioral-health appointments. For example, the children’s 

therapist, who could provide detailed knowledge about the children’s 

medical and behavioral needs, offered to meet with Mother but Mother did 

not do so. Had Mother attended C.M.’s feeding therapies, she could have 

obtained “really specific[,] detailed information” about his diet, but Mother 

only attended a few.

¶19 Mother also attended only half of the CFT meetings, which 

are intended to “bring together all of the people that are involved in the 
MARSHA M. v. DCS, et al.

Decision of the Court

6 

child’s care so [they] can all talk about what’s going on with the child, the 

child’s needs, the child’s current functioning, areas of concerns, and work 

together to try and support the child.” There, several of the children’s 

providers discussed the children’s specific needs and upcoming 

appointments. Accordingly, in May 2017, the case manager testified that 

Mother still needed “to learn the certain skill sets [for the children’s special 

needs] and be able to demonstrate that she understands how to use those 

skills.” 

¶20 The children’s needs are very extensive. L.M. has substantial

mental health needs, particularly from her post-traumatic stress disorder. 

She regularly attends counseling and shows “a variety of different trauma 

symptoms including hyper vigilance, exaggerated startle response, 

nightmares, sleep disruptions, [and] difficulty falling asleep. At times she 

appears to disassociate.” She also becomes “highly anxious,” causing 

extended silence or stuttering and increased toileting accidents and sleep 

disruptions. Since age one, L.M. has also displayed “compulsive sexualized 

behaviors that were outside the typical range for a child of her age.” L.M.’s 

therapist testified that it is: 

crucial [for L.M.’s long-term mental health] that she has safety 

and stability and permanency and predictability within her 

primary care giving relationship. She will rely on that person. 

She needs to have a person who she feels confident [in] and 

can trust, . . . someone that she feels can keep her safe and can 

protect her from any potential dangers. And these pieces are 

crucial for her long-term mental health. Any -- further risk 

factors or exposure to violence or inconsistency or 

unpredictable life really puts her at further risk for 

developing serious mental illness as she gets older.

¶21 C.M. has long-term medical and developmental needs. He 

easily aspirates, so he is on a restricted diet and needs his liquids thickened. 

Without proper care, he is at high risk for developing pneumonia; “[w]ithin 

a matter of 24 hours [the situation] can be[come] very serious.” Indeed, 

C.M. had been hospitalized six times since his birth. He also had bleeding 

in his brain around the time of his birth and consequently developed “low 

or weak muscle tone on the left side of his body which has impacted several 

areas of functioning.” His speech functioning is “significantly delayed.”

Overall, he is developmentally delayed and has been diagnosed with 

cerebral palsy and celiac disease. Most recently, C.M. was diagnosed with 

disinhibited social engagement disorder, meaning he lacks wariness with 

strangers, which “puts him at high risk . . . to be victimized if he’s not . . . 

highly supervised in public at all times.”
MARSHA M. v. DCS, et al.

Decision of the Court

7 

¶22 To address these needs, C.M. requires continuous medical 

and developmental services. C.M. attends feeding therapy four days per 

week and regular breathing treatments, counseling, physical therapy, and 

occupational therapy appointments. He also sees a variety of doctors 

specializing in neurology, gastrointestinal medicine, pulmonology, 

orthopedic medicine, allergies, and ear, nose, and throat issues. 

Accordingly, C.M.’s therapist testified that his caregiver must be very 

efficient in coordinating and multitasking and “consistently attend . . . and 

actively participate in” C.M.’s services. Without a caregiver who 

consistently attends every appointment, C.M. could suffer “a significant 

risk to his physical health but also [to] his developmental capacities.”

Overall, the children’s therapist testified that a caregiver who is “able to 

take in the new information that the doctors are providing and . . . able to 

implement that consistently is crucial for these kids.”

¶23 After May 2017, DCS provided Mother with additional 

opportunities to demonstrate her ability to care for L.M. and C.M. DCS 

provided Mother with detailed instructions on the children’s upcoming 

appointments and reiterated to her that she needed to attend every 

appointment and CFT. Mother received instruction on how to thicken 

C.M.’s liquids at his feeding therapies at Phoenix Children’s Hospital. The 

children’s therapist knew about each child’s behavioral and medical issues

and invited Mother to regularly meet with her and attend some of the 

children’s therapy appointments. DCS allowed Mother to lead the CFT 

meetings, giving her an opportunity to display her knowledge about the 

children’s needs and their upcoming appointments. Finally, for five months 

preceding the termination hearing, DCS provided Mother with a third 

parent aide who supervised four-hour visits twice a week in Mother’s 

home. That parent aide educated herself on the children’s special needs 

through the placement because Mother failed to provide her detailed 

information on C.M.’s medical issues.

¶24 Despite these additional opportunities, Mother still missed a 

number of the children’s appointments after May 2017. For example,

several of C.M.’s specialists held a joint meeting at which they detailed his

restrictive diet; Mother did not appear, and the meeting had to be 

rescheduled. Moreover, Mother struggled with remembering instructions 

and adequately grasping the children’s needs. She provided incomplete 

information while leading the CFT meetings and had trouble explaining the 

purpose and outcome of each medical appointment. Despite having 

received instructions on C.M.’s restricted diet, Mother attempted to feed 

him a strawberry, which could have caused him to aspirate.
MARSHA M. v. DCS, et al.

Decision of the Court

8 

¶25 Nor did Mother demonstrate awareness of L.M.’s emotional 

needs, including her need for extra protection due to her anxiety. At an 

encounter with both parents and placement, Mother pushed L.M. to engage 

with Father and failed to notice that L.M. was “not feeling safe,” even 

though she was “physically . . . tensing up. Her eyes [were] getting bigger. 

She[ was] refusing to go.” At the termination hearing, Mother could not 

explain why C.M. sees a pulmonologist or attends occupational therapy

and she could not explain which doctor’s appointments she had attended. 

¶26 Mother also struggled with properly supervising the children 

during visits. The parent aide testified that Mother had difficulty retaining 

basic parenting directions and the parent aide often had to “intervene[] and 

remind[]” her. At one visit, L.M. ate part of a glow stick, and the parent aide 

had to call poison control and instruct Mother to wash out L.M.’s mouth. 

At other visits, L.M. tried to drink cleaning supplies, microwave her metal 

lunch box, and touch a hot stove. Each time, the parent aide had to redirect 

her. At a visit just before the termination hearing, Mother failed to redirect 

L.M. when she almost tipped over a recliner. Finally, the parent aide 

expressed concern that at times, Mother “sit[s] on the couch, and it seems 

like she is watching TV. But then when [the children] . . . walk up to her, 

she kind of is staring, looking forward, not moving, not reacting when the 

children are attempting to get her attention.” Ultimately, the parent aide 

did not recommend unsupervised visits.

¶27 Considering this record, reasonable evidence supports the 

court’s finding that DCS gave Mother the time and opportunity to learn 

about and demonstrate her knowledge of the children’s special needs.

¶28 Because we affirm the juvenile court’s ruling on the fifteen

months’ time in care ground, we decline to address the findings concerning 

the mental health ground. Jesus M. v. Ariz. Dep’t of Econ. Sec., 203 Ariz. 278, 

280, ¶ 3 (App. 2002) (“If clear and convincing evidence supports any one of 

the statutory grounds on which the juvenile court ordered severance, we 

need not address claims pertaining to the other grounds.”). Mother does 

not appeal the juvenile court’s best interests finding, and thus we do not 

address it. Ariz. R. Civ. App. P. 13(a)(7); Ariz. R. P. Juv. Ct. 106(a); In re J.U., 

241 Ariz. 156, 161, ¶ 18 (App. 2016). 
MARSHA M. v. DCS, et al.

Decision of the Court

9 

CONCLUSION

¶29 We affirm the superior court’s order terminating Mother’s 

parental rights.