Illinois Official Reports 

Appellate Court

In re Fatima A., 2015 IL App (1st) 133258

Appellate Court 

Caption

In re FATIMA A., a Minor (Robert F. Harris, Cook County Public 

Guardian, Plaintiff-Appellant, v. The Department of Children and 

Family Services, an Administrative Agency in the State of Illinois; 

Bobbie Gregg, Acting Director of Children and Family Services; and 

Arthur Sutton, Administrative Law Judge in the Administrative 

Hearings Unit of the Department of Children and Family Services, 

Defendants-Appellees).

District & No. First District, First Division

Docket No. 1-13-3258

Filed February 2, 2015

Held

(Note: This syllabus 

constitutes no part of the 

opinion of the court but 

has been prepared by the 

Reporter of Decisions 

for the convenience of 

the reader.)

The trial court’s order affirming the decision of the Director of the 

Department of Children and Family Services upholding the denial of 

specialized foster care services for a minor was affirmed, 

notwithstanding the public guardian’s contentions, inter alia, that the 

decision was legally erroneous in concluding that the minor was not 

eligible for specialized care because her needs were being met and that 

DCFS had met its burden of showing that the denial of specialized 

care was consistent with the minor’s well-being, and that the decision 

was a denial of due process and arbitrary and capricious, since all of 

the relevant factors were considered and the decision to deny 

specialization was not clearly erroneous.

Decision Under 

Review

Appeal from the Circuit Court of Cook County, No. 11-CH-31027; the 

Hon. Franklin Valderrama, Judge, presiding.

Judgment Affirmed.
- 2 - 

Counsel on

Appeal

Robert F. Harris, Public Guardian, of Chicago (Kass A. Plain and Jean 

M. Agathen, of counsel), for appellant.

Lisa Madigan, Attorney General, of Chicago (Carolyn E. Shapiro, 

Solicitor General, and Ann C. Maskaleris, Assistant Attorney General, 

of counsel), for appellees.

Panel JUSTICE CONNORS delivered the judgment of the court, with 

opinion.

Presiding Justice Delort and Justice Harris concurred in the judgment 

and opinion.

 OPINION 

¶ 1 The plaintiff, Cook County public guardian, appeals on behalf of the minor, Fatima A. 

(Fatima), from the circuit court’s order affirming a decision of defendant Erwin McEwen 

(Director),1

 the Director of defendant Department of Children and Family Services (DCFS) 

upholding the denial of specialized foster care services for the minor. Plaintiff alleges that: (1) 

the final administrative decision was against the manifest weight of the evidence because the 

decision found that all of the minor’s needs were being met despite the fact that Fatima had 

severe eczema and had not yet seen a dermatologist; (2) the final administrative decision was 

legally erroneous where it concluded that the minor was not eligible for specialized care 

because her needs were being met; (3) the final administrative decision was clearly erroneous 

where it concluded that DCFS had met its burden of showing that the decision to deny 

specialized care was consistent with her well-being despite Fatima’s severe medical and 

behavioral problems; and (4) the final administrative decision constituted a denial of due 

process and a violation of the Illinois Administrative Procedure Act (5 ILCS 100/1-1 et seq. 

(West 2012)), where it was arbitrary and capricious. For the following reasons, we affirm. 

¶ 2 BACKGROUND 

¶ 3 On October 18, 2010, DCFS’s Child and Youth Investment Team (CAYIT) denied the 

request of Melanie B., Fatima’s guardian, for specialized foster care services for the minor. 

Melanie B. appealed that finding. 

¶ 4 On May 20, 2011, a hearing was held before an administrative law judge (ALJ) at the 

DCFS Administrative Hearings Unit. The ALJ first noted that Melanie B., as Fatima’s 

guardian, had the burden of proof in this case, not DCFS. Melanie B.’s counsel preserved for 

appeal the issue of burden of proof, stating that it was counsel’s belief that DCFS had the 

 

1

Pursuant to section 2-1008(d) of the Illinois Code of Civil Procedure (735 ILCS 5/2-1008(d) 

(West 2012)), we have amended the caption to correctly reflect the current department acting director. 

On our own motion, we hereby substitute her as a party as shown above. 
- 3 - 

burden of proof by a preponderance of the evidence to show that the action it took was in the 

best interest of the child. 

¶ 5 Melanie B. testified first, stating that Fatima was placed in her home when she was 11 days 

old and was now 3 years old. When she was first placed in the home, Fatima had severe acid 

reflux and muscle rigidity on one side of her body due to drug exposure in utero. Fatima began 

physical therapy in May 2008 and was discharged a little over a year later. It was 

recommended that she continue exercises like swimming, which the minor could not do due to 

tubes in her ears. Melanie B. testified that Fatima was in gym classes and ballet classes at the 

time of the hearing. The gym classes were at a private facility because the facility disinfected 

the room before and after classes, whereas the park district facilities did not. Due to Fatima’s 

allergies, this was necessary. Melanie B. testified that Fatima had both food and other allergies. 

Her food allergies were dairy (especially milk), soy, citrus, and eggs. The dairy allergy was 

both by ingestion and by touch. If Fatima touched milk, she “immediately welt[ed] up, 

start[ed] itching” and her eczema flared up. Ingesting it “close[d] her throat” and made her 

vomit. Soy caused upset stomachs, and citrus caused open sores in her mouth. Eggs caused 

Fatima’s eczema to flare up.

¶ 6 Melanie B. testified that Fatima also had asthma and eczema. Her skin got very dry and 

scaly from her neck down. She had a prescription cream that Melanie B. put on her every night. 

She also had two topical creams. She kept a prescription medication for eczema at Fatima’s 

school as well. 

¶ 7 Melanie B. testified that Fatima’s other allergies included dog dander, bug spray, and wool. 

Fatima’s skin raised up wherever her eczema was when she touched dog dander, which would 

cause her to scratch the skin and bleed. Bug spray caused welts and throat closing. Wool 

caused “contact dermatitis.”

¶ 8 Melanie B. further testified that Fatima was on prescription medicine for each different 

allergy. Melanie B. stated that she has hypoallergenic air purifiers in every room and a 

hypoallergenic vacuum at home. She also has special sheets, bedding, pillowcases, detergents, 

soaps, lotions, and wipes for Fatima. Melanie B. testified that she also has medication for her 

food allergies, besides an epinephrine pen (epi pen). Fatima is also on prescription eye drops 

for eye infections. 

¶ 9 Melanie B. further testified that Fatima was in behavioral therapy at Illinois Masonic with 

Jennifer Bailey, which started January 5, 2011. Fatima was also in art therapy at school, which 

was recommended by her social worker at school after she refused to answer test questions 

during routine testing. At the time of the hearing, she did art therapy once a week. Melanie B. 

testified that Fatima’s school social worker also recommended individual therapy and gave her 

a phone number at Illinois Masonic. Melanie B. testified that Fatima’s pediatrician also agreed 

that therapy would benefit Fatima because her “tantruming” was becoming out of control. 

Melanie B. initiated the therapy because Fatima’s home behavior was becoming erratic. She 

was “tantruming,” crying for long hours at a time, shutting down in social situations, and 

becoming paranoid in public settings. 

¶ 10 Melanie B. testified that Fatima was also becoming abusive toward her and her biological 

daughter. She testified that Fatima would “hit us, pinch, bite, kick.” Melanie B. testified that 

Fatima saw Bailey at Illinois Masonic once a week. Bailey also did family therapy with 

Melanie B. and occasionally with her biological daughter. Melanie B. testified that she went to 
- 4 - 

an eight-week-long parenting class for children with disruptive behaviors and talked to Bailey 

about what she learned. 

¶ 11 On cross-examination, Melanie B. testified that Fatima generally did not have acid reflux 

anymore and that the physical therapy for Fatima’s muscle rigidity was terminated because it 

was successful. She testified that Fatima had never been to an allergist but that her doctor was 

going to refer her to one. 

¶ 12 Melanie B. further testified on cross-examination that Fatima no longer has ear infections 

and that she passed her hearing tests after the tubes were put in her ears. Fatima is also no 

longer in need of a speech therapist. Melanie B. testified that the “tantruming” did not happen 

as often at school as it did at home. 

¶ 13 Melanie B. further testified that Fatima’s mother’s rights were terminated in January 2011, 

and the goal was now adoption, regardless of whether Fatima was considered specialized or 

not. She testified that all the services she had described, including therapy, were covered by 

“the medical card,” which Melanie B. did not have to pay for. She testified that the 

prescriptions were also paid for by the medical card. Melanie B. testified that Fatima’s gym 

classes were covered by DCFS’s monthly board check. She received $392 or $397 monthly for 

Fatima, plus $100 every month for gym classes. 

¶ 14 Melanie B. testified that if Fatima was considered specialized and she received extra 

money, she would use the money for other classes and equipment she needs in the house that is 

not covered by the medical card. She also has to purchase bedding every three months for 

Fatima, as DCFS purchased the original bedding, but not the replacement bedding. DCFS also 

purchased the original air purifiers, but Melanie B. testified it would not purchase the 

replacements. Melanie B. also testified that she wanted a respite worker from DCFS because 

she could not leave Fatima with “just anyone.”

¶ 15 Finally, Melanie B. testified that it was her belief that, after adoption, Fatima’s behavioral 

therapy would be covered through the medical card. 

¶ 16 It was then stipulated that if called to testify Jennifer Bailey would state that she is a 

behavioral clinician at Illinois Masonic. In her initial assessment of Fatima, she determined 

that Fatima needed weekly individual therapy as well as family therapy with Melanie B. She 

recommended that Melanie B. engage in a parenting group for parents of children with 

disruptive behavioral problems. Bailey would state that she is addressing issues with Fatima 

that include “violence towards others, tantruming, shutting down in social situations, 

suspicious or paranoid behavior such as thinking that everyone is watching or laughing at the 

minor, and obsessive compulsive disorder behaviors.” Bailey would further testify that Fatima 

“is making very little progress in identifying triggering behaviors.”

¶ 17 DCFS then put on its case, calling Dr. Lia Knox, a CAYIT reviewer, as its first witness. 

Dr. Knox testified that she had a Ph.D. in psychology. She was present at the CAYIT staffing 

that occurred on October 18, 2010, in regard to Fatima. The purpose of the CAYIT was to talk 

about placement and specialized care for Fatima. Dr. Knox testified that in order to receive 

specialized care, a minor has to have certain medical issues, psychological issues, or 

behavioral issues that warrant more services from DCFS. 

¶ 18 Dr. Knox further testified that whether a minor should receive specialized care is covered 

by section 301.90(b) of Title 89 of the Illinois Administrative Code (Code) (89 Ill. Adm. Code 

301.90(b) (2010)), which states that the first thing that would need to occur would be a CAYIT 
- 5 - 

staffing, which did occur in this case. Dr. Knox testified that examples of minors that require 

specialized care included minors with an IQ of 70 or below, “which is in the mental retardation 

realm,” minors with certain medical issues that require more hospitalization or more medical 

care, autistic children who tend to have moderate behavioral, perception, and sensory issues, 

children in need of behavioral care or who have highly sexualized behavior and cannot be 

around other children, and adolescents whose behavior has caused them to be placed in several 

different homes. 

¶ 19 Dr. Knox acknowledged that the portion of the rule at issue here was whether Fatima had a 

medical or physical condition or impairment that required an extraordinary level of daily 

supervision or assistance. Dr. Knox testified that an example of a minor that would fall under 

this category would be one who had breathing tubes or walking instruments to aid in walking, 

or a child who had a brain injury that caused seizures. She further testified that children with 

Down’s syndrome or paralysis or neurological problems would fall into this category.

¶ 20 Dr. Knox further testified that from what she remembered, Fatima was very active at home, 

was playful, “a joy to be with,” inquisitive, and curious. Dr. Knox testified that Fatima did well 

in school and was a leader. She was able to get along with other kids “very well.”

¶ 21 She further testified that Fatima would not qualify for specialized foster care when looking 

at the four factors listed in the Code: (1) the child’s individual function in the home, school, 

and community; (2) the child’s current or recommended involvement in identified services; (3) 

the child’s degree of need; and (4) the caregiver’s required level of participation in activities 

and/or services needed to meet the child’s treatment and educational needs. Dr. Knox testified 

that Fatima would not qualify under the first provision because she was doing well and her 

medical needs were being taken care of. She had special lotion for her skin and had the 

appropriate medical checks on time. Dr. Knox testified that Fatima would not meet the second 

factor either because she was functioning well both at school and at home. In regard to the third 

factor, Dr. Knox testified that Fatima had received the medical care she needed and that Fatima 

was stable when she saw her. Finally, Dr. Knox testified that Fatima did not qualify under the 

fourth factor either because Melanie B. was meeting all of Fatima’s needs.

¶ 22 Dr. Knox testified that the primary goal in regard to specialized foster care is to make sure 

that both the child and the family have the appropriate services in place to maintain a child in 

that home so there are no disruptions and the child receives the best care possible. 

¶ 23 On cross-examination Dr. Knox stated that she was unaware that Fatima was in family 

therapy, that Fatima had been diagnosed with disruptive behavior disorder, that she was being 

treated for obsessive-compulsive behaviors, that she was being treated for paranoid behaviors, 

or that she required eight or more prescriptions a day. Dr. Knox testified that knowing those 

things would not change her opinion that Fatima’s needs were being met, however, since 

Fatima was receiving those prescriptions and attending therapy and did not seem to need 

additional services. 

¶ 24 DCFS then rested, and the ALJ asked Melanie B. a few additional questions. In response, 

Melanie B. stated that the prescriptions and the doctors were the only services covered by the 

medical card and that she wanted additional money. She was not receiving financial assistance 

with art therapy, food, drinks, soaps, shampoos, detergents, bedding, or air purifiers. Melanie 

B. testified that she was told that once Fatima was adopted, DCFS no longer had any 

responsibility for anything not provided by the medical card. 
- 6 - 

¶ 25 On June 14, 2011, the ALJ issued a recommendation and opinion, finding that Melanie B. 

did not meet her burden of proof, thereby denying her appeal from CAYIT’s denial of 

specialized care. On September 1, 2011, plaintiff filed a complaint for administrative review in 

the circuit court. On April 26, 2012, the circuit court entered an agreed order remanding the 

matter to DCFS for reconsideration of the denial of specialization and for a supplemental 

hearing with instructions to allow new evidence as necessary, current up through the 

supplemental hearing date, with the burden of proof on DCFS instead of Melanie B. 

¶ 26 A subsequent hearing was held on July 18, 2012. The ALJ noted that this hearing would 

leave off from the prior hearing, instead of resubmitting all the evidence and testimony that 

was given at that time. Tanya Parker, a DCFS worker assigned to Fatima’s case, testified first. 

Parker testified that she was assigned to Fatima’s case in May 2011 and that Fatima is now four 

years old. She testified that Fatima has visible eczema all over her body and has certain food 

and environmental allergies. Parker testified that Fatima has high anxiety. 

¶ 27 Parker further testified that Fatima is allergic to dairy, grass, dander, mold, pollen, and cats. 

She is currently on medication for her allergies and has gone to see a specialist at North Shore 

University Health System. Dr. Rachel Story prescribed creams for Fatima’s eczema. Parker 

testified that Fatima has asthma, but has prescribed medication for that, as well as a nebulizer. 

Parker testified that the doctor has stated that her allergies are currently under control. 

¶ 28 Parker testified that Fatima went to the doctor in February 2012 for an asthma attack and 

was hospitalized in March 2012 for pneumonia. 

¶ 29 Parker further testified that Fatima was in individual therapy for behavioral management. 

Brittany Neef, the therapist from Advocate Illinois Masonic Medical Center, was Fatima’s 

therapist. Parker testified that Neef indicated in a June 13, 2012, report that Fatima was 

referred to the Pediatric Developmental Center for a comprehensive evaluation. It was then 

recommended after the comprehensive evaluation that Fatima needed group therapy. Fatima is 

currently on a waiting list for the group therapy. Parker testified that the parent must go to 

therapy first before the child can attend either group therapy or parent/child therapy, and that 

Melanie B. was currently in therapy. Parker testified that individual therapy ended in May 

2012 when Neef left the practice. Parker testified that Fatima was still in art therapy at school. 

¶ 30 Parker further testified that Fatima does not exhibit the same behaviors at school as she 

does in the foster home and that the school has not reported any concerns regarding Fatima’s 

behavior. Parker testified that Fatima underwent a developmental and behavioral diagnostic 

summary on February 22, 2012, after which Dr. Cupoli stated Fatima exhibited anxiety issues. 

¶ 31 Parker additionally testified that Fatima was referred to System of Care (SOC) in June 

2012, due to “this appeal” and “things that were going on.” Parker testified that members of 

SOC had met with Fatima at least four times and that, at the conclusion of the initial 

assessment, it was concluded that Fatima probably did not qualify for SOC services because 

she was receiving community-based services. 

¶ 32 Parker testified that Melanie B. “absolutely” wanted to adopt Fatima and that Fatima 

functions in the home as if Melanie B. is her mother. Parker testified that Fatima is very 

attached to Melanie B. and very attached to Melanie B.’s biological daughter. Parker testified 

that Melanie B.’s mother lives upstairs from them and that Fatima is attached to her

grandparents as well. During Parker’s visits, Fatima “[e]ngages in play.” Parker testified that 

Fatima has a nice bedroom and that Melanie B. makes sure all of Fatima’s needs are met. 
- 7 - 

Parker further testified that Fatima is very aware of her allergies and problems and she has 

been “taught and trained” about them.

¶ 33 Parker testified that at school Fatima seems overall pleasant, but more of a loner. Other 

children have to engage Fatima in order for her to play with them. Fatima has had some 

incidents where she has gotten into fights with her peers or does not want to share, but that is 

not a daily occurrence. 

¶ 34 On cross-examination, Parker testified that Melanie B. regularly reported “tantruming” and 

violence at home and that Fatima occasionally had paranoia. Parker further testified that 

Melanie B. had recently reported to her that Fatima had compulsive behaviors, that she was 

shutting down, and that she was exhibiting avoidance behaviors. Parker further stated that she 

was aware that Melanie B.’s biological daughter was seeking therapy because of Fatima’s 

behavior in the home. Parker testified that all of Fatima’s needs were being met and would 

continue to be met once adoption was finalized. 

¶ 35 Melanie B. then testified on behalf of Fatima. She testified that Fatima is still allergic to 

soy, egg, citrus, all dairy, dog dander, wool, and bug spray. She testified that Fatima was 

seeing an allergist, Dr. Story, who was referred by Fatima’s pediatrician. Melanie B. testified 

that she called Children’s Memorial Hospital looking for a dermatologist for Fatima, but she 

was told to call back on August 13, 2012, as they were booked through October. 

¶ 36 Melanie B. testified that a second series of allergy tests revealed that Fatima was allergic to 

cats, tall grass, birch trees, penicillin, dust mites, and cockroaches. Melanie B. testified that the 

treatment for Fatima’s allergies is the same, except that two of the medications have increased 

in strength. The prescriptions and creams are covered by the medical card, but the lotions are 

not. Melanie B. testified that she has to purchase “extra that are not covered by the medical 

card because [she is] only allowed one each time.” Melanie B. stated that she uses the medical 

card to purchase one prescription and then she pays out of pocket for duplicates or she buys a 

generic brand. 

¶ 37 Melanie B. testified that in June 2013, Fatima went to the emergency room due to swelling 

on her throat after a lotion was applied. The emergency room doctor recommended a mold 

machine for Fatima, so Melanie B. purchased one for Fatima’s bedroom as well as one for the 

living room, and DCFS did not reimburse her for either. The doctor also recommended an 

air-conditioner in the summer and a dehumidifier in the winter for her allergies and asthma. 

¶ 38 Melanie B. testified that Fatima’s behavior is still the same as it was when she testified at 

the prior hearing, but that Fatima’s violent behavior and “tantruming” have increased.

¶ 39 Melanie B. further testified that Neef, at Illinois Masonic, recommended to Melanie B. that 

Fatima attend Erikson Institute because Neef “wasn’t getting anywhere with her in therapy,” 

and Fatima was having tantrums in therapy. Erikson Institute no longer had a contract with 

DCFS, however, so Neef referred her to the Pediatric Development Center (the Center). 

Melanie B. testified that she was taking parenting classes as a prerequisite to Fatima’s ability to 

participate in group therapy but that she had been on a waiting list for a long time before 

getting into class because Fatima “has a medical card.” Melanie B. testified that, today, Fatima 

is not in any services at the Center. The therapy sessions will be weekly when they start. 

Melanie B. further testified that she attempted to register Fatima in daycare at the Center once 

but was told it could not accommodate Fatima’s allergy needs since other children brought in 

outside food that could not be controlled. 
- 8 - 

¶ 40 When asked what services, other than seeking a dermatologist, that Melanie B. needed 

assistance with, she stated that she was “still waiting on vouchers for *** the sheets, the 

bedding, pillow cases, the air machines.” Melanie B. stated that she is trying to meet all of 

Fatima’s needs at this time as best she can with the doctors and additional services, but Fatima 

is constantly changing. Melanie B. testified that right now, with the “services that are going to 

be put in place,” she is meeting Fatima’s needs.

¶ 41 Melanie B. further testified that Fatima has never been hospitalized and that she has only 

ever been to the emergency room. She testified that she has not talked to a doctor about getting 

a bigger dose of medication at a time, but she talked to the pharmacist who informed her that 

her “medical card only covers a certain amount.”

¶ 42 Finally, Melanie B. testified that once she adopts Fatima, she will not get the extra money 

for gym class, bedding, air machines, and receipts “to purchase extra stuff.” Melanie B. 

testified that she is only looking for more money, not specialized services. 

¶ 43 On September 17, 2012, DCFS issued an opinion in which it noted that the issue on remand 

was whether a preponderance of the evidence supported DCFS’s decision to deny Melanie B.’s 

request for specialized foster care. It made the following relevant findings of fact. Fatima was 

diagnosed with asthma, atopic eczema, acid reflux, problems with her ears, and mental health 

and anxiety issues that require constant attention. Fatima no longer has tubes in her ears, no 

longer has acid reflux or ear infections, and is on track for speech and language. Fatima is no 

longer in need of services for speech or language. She is still allergic to dairy products, is 

currently on “medication for allergy,” and needs a nebulizer for asthma. Fatima was 

hospitalized in February 2012 for an asthma flare up. She needs group and individual child 

therapy. The decision stated that there were off-and-on behavioral problems at school and that 

Fatima had been involved in fights with boys. However, school reports showed that Fatima 

was doing well and did not state any concerns. 

¶ 44 The ALJ further found that Fatima was receiving a special fee every six months and that 

she still had hypoallergenic issues. It further found that “[a]ll needs are being met by foster 

parent through community based services.” It found no risk of harm to Fatima and that her 

current placement was safe. Since May of 2011, there had been no unusual incidents reported. 

The court further found that Fatima received $100 toward gym classes. DCFS further stated in 

its decision: “Dermatologist is booked until October, 2012; all creams covered by medical card 

accept [sic] one. Department did not pay for mold machine because no receipt was presented; 

no receipt was presented for dehumidifier; sheets, bedding and pillows are covered by DCFS.”

¶ 45 The ALJ stated that Fatima was involved in gymnastics, which costs $430 for 20 sessions 

and $280 for short sessions. Lastly, the ALJ found that DCFS’s witnesses testified credibly.

¶ 46 In addition to those findings of fact, the ALJ made conclusions of law. It found in pertinent 

part that DCFS had proven by a preponderance of the evidence that the decision made by 

DCFS to deny specialization was consistent with Fatima’s needs regarding safety, well-being, 

and permanency pursuant to part 337 of Title 89 of the Code (89 Ill. Adm. Code 337). 

¶ 47 In its analysis, the ALJ took judicial notice of the testimony and exhibits offered into 

evidence during the original hearing on May 20, 2011. The ALJ noted that DCFS argued that 

all of Fatima’s needs were being met through current services “already being provided.” The 

ALJ noted that Melanie B. located resources to help Fatima with her medical and behavioral 

needs and is committed to her well-being. It noted that Fatima was on a waiting list to receive 

occupational therapy at Illinois Masonic and that Fatima is in art therapy and will be 
- 9 - 

continuing these services. Melanie B. will be contacting Children’s Memorial Hospital to 

inquire about a dermatologist appointment. Fatima’s mental health needs “are also being 

addressed through a variety of service providers.”

¶ 48 The ALJ found that “the Appellant[ ] could not show where the minor is in need of any 

services that were not already being addressed or that could only be provided through 

specialization.” Moreover, the ALJ found, “there has been no showing that [DCFS] is not 

addressing the necessary services needed for [Fatima].” The ALJ continued, “[h]ere, 

[Fatima’s] needs are being met through foster care services already available and in place.” 

The ALJ found that DCFS sustained its burden and the decision to deny the request for 

specialization was reasonable and consistent with Fatima’s needs with regard to safety, 

well-being, and permanency. 

¶ 49 Plaintiff then appealed to the circuit court for administrative review pursuant to section 

3-101 of the Illinois Code of Civil Procedure. 735 ILCS 5/3-101 (West 2012). The court issued 

a memorandum and order on October 8, 2013, in which it found, with regard to the question of 

law regarding whether DCFS properly applied the factors listed in section 301.90(b), that 

DCFS properly applied section 301.90(b) where it required a recommendation of the CAYIT 

and where evidence showed that the CAYIT reviewed the four factors in section 301.90(b) 

before determining specialized foster care was not needed. 

¶ 50 For the mixed question of law and fact, of whether Fatima qualified for specialization, the 

court found that DCFS properly analyzed section 301.90(b), which outlines the assessment for 

specialization of a foster child. The court found that in taking the section into consideration, the 

ALJ properly considered each factor and found that Fatima did not qualify for specialization 

based on testimony and exhibits provided at the hearing. The court found that, therefore, the 

ALJ’s decision was not clearly erroneous.

¶ 51 In terms of plaintiff’s question of fact, regarding whether the ALJ’s decision was against 

the manifest weight of the evidence, the court found that the evidence supported the ALJ’s 

decision to deny Melanie B.’s request for specialization. The court found that the ALJ had 

considered testimony from Dr. Knox, Melanie B., and Tanya Parker regarding Fatima’s 

medical and behavioral issues and needs. The ALJ found those witnesses to be credible and 

agreed with the conclusion of Dr. Knox that Fatima did not qualify for specialization. 

Accordingly, the court found that the record supported the findings of the ALJ and that the 

decision was therefore not against the manifest weight of the evidence. 

¶ 52 Lastly, plaintiff argued that the ALJ violated Fatima’s due process rights and the Illinois 

Administrative Procedure Act by imposing requirements for eligibility beyond those in DCFS 

rules. The court found that plaintiff did not provide the court with any evidence to support the 

proposition that DCFS’s decision was arbitrary or unreasonable. The court affirmed the ALJ’s 

decision and dismissed plaintiff’s complaint for administrative review. Plaintiff now appeals.

¶ 53 ANALYSIS 

¶ 54 Plaintiff contends on appeal that the final administrative decision by the ALJ was (1) 

against the manifest weight of the evidence where it found that all of Fatima’s needs were 

being met despite her severe eczema and the fact that she had not yet seen a dermatologist; (2) 

legally erroneous where it ignored the benefits of the specialization program and added an 

improper requirement; (3) clearly erroneous where if found that DCFS had met its burden of 

showing that denial of specialization was consistent with Fatima’s well-being despite Fatima’s 
- 10 - 

physical and behavioral issues that required constant attention; and (4) arbitrary and capricious 

in failing to consider important aspects of Fatima’s conditions and improperly adding a 

requirement for specialized care. For the following reasons, we affirm the final administrative 

decision. 

¶ 55 The Administrative Review Law provides that a final decision of the circuit court 

reviewing the decision of an administrative agency is “reviewable by appeal as in other civil 

cases.” 735 ILCS 5/3-112 (West 2012). This court reviews the agency’s decision, not the 

circuit court’s decision. Marconi v. Chicago Heights Police Pension Board, 225 Ill. 2d 497, 

531 (2006). 

¶ 56 Standard of Review 

¶ 57 At the hearings in this case, DCFS carried the burden of proof in showing, by a 

preponderance of the evidence, that the decision made by CAYIT to deny specialization was in 

the best interests of the child “in accordance with professional social work standards and 

[DCFS] administrative rules.” 89 Ill. Adm. Code 337.170(a) (2002); 89 Ill. Adm. Code 

337.30(d), amended at 26 Ill. Reg. 6246 (eff. June 1, 2002). On administrative review, the 

standard of review applied depends on the issues presented: a question of fact, a question of 

law, or a mixed question of fact and law. Cinkus v. Village of Stickney Municipal Officers 

Electoral Board, 228 Ill. 2d 200, 210 (2008). 

¶ 58 Where the question of an agency’s decision is one of fact, an administrative agency’s 

findings and conclusions of fact are deemed to be prima facie true and correct. 735 ILCS 

5/3-110 (West 2012); O’Boyle v. Personnel Board, 119 Ill. App. 3d 648, 653 (1983). In 

examining an administrative agency’s factual findings, a reviewing court does not weigh the 

evidence or substitute its judgment for that of the agency. Cinkus, 228 Ill. 2d at 210. If the issue 

before the reviewing court is merely one of conflicting testimony and credibility of witnesses, 

the administrative board’s decision should be sustained. O’Boyle, 119 Ill. App. 3d at 653. A 

reviewing court is limited to ascertaining whether such findings of fact are against the manifest 

weight of the evidence. City of Belvidere v. Illinois State Labor Relations Board, 181 Ill. 2d 

191, 204 (1998). An administrative agency’s factual findings are against the manifest weight 

of the evidence if no trier of fact could have agreed with the agency or an opposite conclusion 

than that reached by the agency is clearly evident. Wade v. City of North Chicago Police 

Pension Board, 226 Ill. 2d 485, 504 (2007). 

¶ 59 When an agency’s decision deals with a question of law, the agency’s findings are not 

binding on a reviewing court and the agency’s decision is reviewed de novo. Cinkus, 228 Ill. 2d 

at 210. 

¶ 60 And finally, mixed questions of law and fact are questions in which the historical facts are 

admitted or established, the rule of law is undisputed, and the issue is whether the facts satisfy 

the statutory standard. Cinkus, 228 Ill. 2d at 211. Where a question of an agency’s decision is a 

mixed question of law and fact, it is subject to the “clearly erroneous” standard of review. 

Marconi, 225 Ill. 2d at 532. An administrative agency’s decision is deemed “clearly 

erroneous” when the reviewing court is left with the definite and firm conviction that a mistake 

has been committed. Cinkus, 228 Ill. 2d at 211. 

¶ 61 Plaintiff contends that all three standards of review apply in this case. 
- 11 - 

¶ 62 Decision Contrary to Manifest Weight of Evidence 

¶ 63 Plaintiff’s first contention on appeal is that the ALJ’s decision made certain fact findings 

that were against the manifest weight of the evidence. We first reiterate that in determining 

whether the decision of the agency was against the manifest weight of the evidence, it is not 

our function to reweigh the evidence or to make an independent determination of the facts. 

Abrahamson v. Illinois Department of Professional Regulation, 153 Ill. 2d 76, 88 (1992). The 

mere fact that an opposite conclusion is reasonable or that a reviewing court might have ruled 

differently will not justify reversal of the findings of fact. Id. “If the record contains evidence 

to support the agency’s decision, it should be affirmed.” Id. Additionally, we note that an 

administrative agency is only required to provide a record and findings to permit orderly and 

efficient review, and if the testimony at the hearing is preserved in the record, as it was in this 

case, “specific fact-findings are not required.” Kimball Dawson, LLC v. City of Chicago 

Department of Zoning, 369 Ill. App. 3d 780, 787 (2006). 

¶ 64 Here, plaintiff contends that certain findings of fact were against the manifest weight of the 

evidence because: (1) all of Fatima’s needs were not being met where she had yet to see a 

dermatologist; (2) the ALJ’s decision did not acknowledge that she was allergic to soy, egg, 

citrus, dog dander, wool, bug spray, cats, tall grass, birch trees, penicillin, mold, dust mites, 

and cockroaches, or her severe reactions to these allergens; (3) the decision did not indicate the 

extreme severity of her eczema or the fact that she had contact dermatitis; (4) while the ALJ’s 

decision mentioned that she was “on medication for allergy,” it did not acknowledge that she 

was on nine daily medications for her allergies; (5) while the ALJ found that all of her creams 

were covered by the medical card except one, it did not acknowledge that Melanie B. had to 

provide duplicates of all of Fatima’s medications to the school; (6) the ALJ’s findings of fact 

stated that the hypoallergenic equipment was not paid for by DCFS because no receipts were 

presented to DCFS despite the fact that Melanie B. testified she was never asked for a receipt 

and was told DCFS would not pay for such expenses; (7) the decision stated that there had been 

no unusual incidents reported since May 2011 despite Melanie B.’s testimony that Fatima had 

been hospitalized for severe allergic reactions; (8) the ALJ found that Fatima’s needs were met 

through community-based services despite the fact that Fatima was not in therapy; (9) the ALJ 

omitted the fact that Fatima was diagnosed with disruptive behavior disorder, as well as a 

sensory regulatory disorder; and (10) the decision stated that Fatima was doing well in school 

when in fact there had been fights with other children. 

¶ 65 We first note that in regard to plaintiff’s arguments that the ALJ failed in its findings of fact 

to list all of Fatima’s specific allergens, failed to list Fatima’s specific medications, failed to 

state the severity of Fatima’s eczema or the fact that she had contact dermatitis, failed to note 

that Melanie B. had to provide duplicate prescriptions to Fatima’s school, and failed to state 

that Fatima had both a sensory regulatory disorder and disruptive behavior disorder, “specific 

fact-findings are not required” where the testimony at the hearing was preserved in the record. 

Kimball Dawson, 369 Ill. App. 3d at 787. Here, the testimony regarding all of these omissions 

in the ALJ’s findings of fact is contained and preserved in the record and therefore was 

considered by the ALJ. Accordingly, we cannot find that the findings of fact were against the 

manifest weight of the evidence merely because not every fact presented at the hearings was 

included. 

¶ 66 Plaintiff next takes issue with the ALJ’s finding that DCFS “did not pay for mold machine 

because no receipt was presented for dehumidifier.” Plaintiff contends that this finding is 
- 12 - 

against the manifest weight of the evidence because Melanie B. testified that she had never 

been asked for a receipt and was told by caseworkers for DCFS that DCFS would not pay for 

such expenses. We note, however, that if the issue before a reviewing court is merely one of 

conflicting testimony and credibility of witnesses, the administrative board’s decision should 

be sustained. O’Boyle, 119 Ill. App. 3d at 653. Here, Parker, the caseworker, specifically 

testified that no receipts had been presented to her and she did not tell Melanie B. that such 

expenses were not covered. Moreover, there was testimony that Melanie B. had submitted 

vouchers and was still waiting to be reimbursed. 

¶ 67 Plaintiff further contends that the finding that there had been no unusual incidents reported 

since May 2011 was against the manifest weight of the evidence because Melanie B. testified 

that Fatima had been hospitalized three times for severe allergic reactions, and Melanie B. had 

notified the caseworker each time. Tonya Parker testified at trial that she had only been 

notified of one trip to the hospital in February 2012. The ALJ specifically found in its findings 

of fact that “[Fatima] was hospitalized in February, 2012 for asthma flare up.” To the extent 

that the ALJ did not specifically find that Melanie B. had reported the other two 

hospitalizations, that decision should be sustained since it is merely one of conflicting 

testimony and credibility of witnesses. O’Boyle, 119 Ill. App. 3d at 653. Accordingly, we do 

not find that the ALJ’s finding that there were no unusual incidents reported since May 2011 

was against the manifest weight of the evidence. 

¶ 68 Plaintiff further contends that the ALJ’s finding that Fatima was doing well in school was 

against the manifest weight of the evidence because “the school had reported to the caseworker 

about fights that [Fatima] had had with other children, and described her behavior as ‘out of the 

norm.’ ” The entire finding of fact made by the ALJ reads: “There are off and on behavior 

problems at school; [Fatima] has been involved in fights with boys in school; school reports 

minor is doing well, did not state any concerns.” We find that this is not against the manifest 

weight of the evidence where Parker testified that the school had not reported any concerns 

regarding Fatima’s behavior, and Dr. Knox testified that Fatima was functioning well in 

school. See O’Boyle, 119 Ill. App. 3d at 653 (findings of agency should be sustained if merely 

one of conflicting testimony and credibility of witnesses). The fact that Fatima gets into 

occasional fights at school does not refute the testimony that she was doing well in school, 

which the ALJ’s findings of fact reflected.

¶ 69 Plaintiff next contends that the finding that Fatima’s needs were being met through 

community-based services was against the manifest weight of the evidence because Fatima 

was not currently in individual therapy. However, at the second hearing, Parker testified that 

Fatima’s individual therapy was on hold while Melanie B. completed parenting classes.

Moreover, Melanie B. testified that once she completely her parenting classes, Fatima was 

eligible for individual, group and child/parent therapy and had been placed on a wait list for 

those services. Accordingly, we find that the ALJ’s finding that Fatima’s needs were being met 

through community-based services was not against the manifest weight of the evidence, as 

Fatima was scheduled to begin individual therapy as soon as Melanie B. completed her 

parenting class. 

¶ 70 Finally, plaintiff contends that the ALJ’s finding that Fatima’s needs were being met was 

against the manifest weight of the evidence where she had not yet seen a dermatologist. 

However, Melanie B. testified at trial that she called Children’s Memorial Hospital looking for 

a dermatologist but was told to call back in August 2012, to make a future appointment since 
- 13 - 

the dermatologist was booked through October 2012. The fact that the dermatologist office 

could not accommodate Fatima at the time of the hearing does not mean that Fatima’s needs 

were not being met. It is apparent from the record that the dermatologist office anticipated 

openings after October, and could accommodate Fatima at that time. Accordingly, it was not 

against the manifest weight of the evidence for the ALJ to find that Fatima’s needs were being 

met despite the fact that Fatima had not yet been able to see a dermatologist. Rather, “[i]f the 

record contains evidence to support the agency’s decision, it should be affirmed.” 

Abrahamson, 153 Ill. 2d at 88. 

¶ 71 ALJ’s Finding That DCFS Met Its Burden Clearly Erroneous 

¶ 72 We next address plaintiff’s contention that the ALJ’s finding that DCFS met its burden of 

proof in showing, by a preponderance of the evidence, that the denial of specialization was in 

the best interests of Fatima, was clearly erroneous. 

¶ 73 At the hearings in this case, DCFS carried the burden of proof in showing, by a 

preponderance of the evidence, that the decision made by CAYIT to deny specialization was in 

the best interests of the child and was consistent with the child’s needs regarding safety, well 

being, and permanency. 89 Ill. Adm. Code 337.170(a) (2002); 89 Ill. Adm. Code 337.30(d), 

amended at 26 Ill. Reg. 6246 (eff. June 1, 2002). 

¶ 74 Section 301.90(b) of Title 89 of the Code defines what makes a child eligible for 

specialized services. It states that DCFS “shall provide specialized foster care services for a 

child *** who requires such services due to emotional, behavioral, developmental or medical 

needs, or any combination thereof, or any other needs which require special intervention 

services.” 89 Ill. Adm. Code 301.90(b) (2010). 

¶ 75 Examples of medical conditions that may require specialized foster care services, as 

provided by the Code, include, but are not limited to: a life-threatening disease; dependence on 

life-saving equipment like a ventilator, dialysis, or oxygen; a medical/physical condition or 

impairment that requires an extraordinary level of daily supervision and/or assistance; 

quadriplegia; severe physical limitations due to multiple physical conditions; hospitalization 

for psychiatric reasons; or being a sexual perpetrator. 89 Ill. Adm. Code 301.90(b)(2) (2010). 

Examples of behavioral and mental health issues that may warrant consideration for 

specialized care include, but are not limited to: sexual victimization; sexual aggression; fire 

setting; juvenile delinquency; compulsive behaviors; mental retardation; or substance abuse 

problems or mental illness. 89 Ill. Adm. Code 301.90(b)(3) (2010). 

¶ 76 When assessing whether a child with one of the above conditions requires specialized 

foster care services, DCFS “shall also consider the following 4 factors, cumulatively”: (1) the 

child’s individual functioning in her home, school, and community; (2) the child’s current or 

recommended involvement in identified services; (3) the child’s degree of need as defined by 

the recommended intensity and/or frequency of services; and (4) the caregiver’s required level 

of participation in activities and services needed to meet the child’s treatment and educational 

needs. 89 Ill. Adm. Code 301.90(b)(4) (2010). 

¶ 77 Plaintiff contends that Fatima “clearly fits” the standard articulated in section 301.90(b) for 

specialization because she has a “medical/physical condition that requires extraordinary 

supervision.” Plaintiff contends that Melanie B. must monitor her special diet and purchase 

special equipment for her home, which must frequently be replaced and are not covered by her 

medical card. Plaintiff further contends that Melanie B. must bring Fatima to several doctors, 
- 14 - 

must administer daily medications, and must make sure Fatima’s school has duplicate 

medications. Plaintiff contends that the Code indicates that asthma, compulsive behaviors, or 

mental illness could qualify a child for specialization and that Fatima has these issues. Further, 

plaintiff contends that looking at the four factors listed in the Code, Fatima should have 

received specialized treatment. 

¶ 78 We first note that the examples of medical, physical, and behavioral conditions listed in the 

Code are described as conditions that “may” require specialized foster care services. The Code 

then goes on to state that when assessing whether a child with one of those listed conditions 

requires special services, DCFS shall also consider four factors, cumulatively. Accordingly, 

the fact that Fatima has any of the enumerated medical, physical, or behavioral conditions does 

not automatically result in a finding of specialization. In this case, all four factors were 

considered, and thus we cannot say that the decision to deny Fatima specialization was clearly 

erroneous. 

¶ 79 In terms of Fatima’s individual functioning at home, at school, and in the community, 

Parker testified that Fatima’s school had not reported any concerns regarding Fatima’s 

behavior, but that she was difficult to engage and had gotten into fights with her peers in the 

past. Parker testified that Fatima engages in play during her visits, she has a nice bedroom, and 

Melanie B. makes sure all of Fatima’s needs are being met. While Fatima has extensive 

allergies, Parker testified that she was on medication for all of her allergies, and that they were 

under control. Melanie B. testified that Fatima exhibited “tantruming” and violent behavior at 

home. 

¶ 80 Looking at Fatima’s current and recommended involvement in identified services, as well 

as the degree of need as defined by the recommended intensity and frequency of services, 

Parker testified that Fatima was in art therapy, is on a waitlist for group therapy, and will be 

back in individual therapy once Melanie B. completes parenting class. Parker further testified 

that Fatima saw a specialist for her allergies and has prescription medication and creams to 

treat them. Melanie B. testified that Fatima has not yet been to see a dermatologist, but was told 

to call back in August to book an appointment after October. Melanie B. also testified that she 

was paying out of pocket for the home equipment replacements, and the duplicate medications 

for Fatima’s school. She further testified that with the services that were going to be put in 

place, she was meeting Fatima’s needs.

¶ 81 Finally, in looking at the caregiver’s required level of participation in activities and 

services needed to meet the child’s treatment and educational needs, we recognize that 

Melanie B.’s required involvement is certainly extensive. She has to administer prescription 

medications daily, apply prescription creams daily, take Fatima to and from several therapy 

appointments a week, as well as frequent doctor appointments, adhere to Fatima’s strict diet, 

provide duplicate medications and creams to Fatima’s school, and keep her home 

hypoallergenic. Melanie B. testified that while Fatima’s needs are currently being met, she 

needs more money to purchase duplicate medications, to purchase food that Fatima is not 

allergic to, and to purchase replacement equipment for her home. However, as the ALJ noted, 

Melanie B. had never attempted to be reimbursed for the duplicate medications or the 

replacement equipment for her home, and she had never asked a doctor for duplicate 

medications. Moreover, considering these four factors cumulatively, we find that the ALJ’s 

decision that DCFS met its burden of proof in showing by a preponderance of the evidence that 

the denial of specialization was in the best interests of Fatima was not clearly erroneous, as we 
- 15 - 

are not left with the definite and firm conviction that a mistake has been committed. Cinkus, 

228 Ill. 2d at 211. 

¶ 82 Consideration of Current Foster Care Services 

¶ 83 Plaintiff also contends that the ALJ improperly considered the current foster care services 

Fatima was receiving in determining whether or not her needs were being met. Specifically, 

plaintiff contends that the Code “nowhere states that simply because a child is getting the 

services she requires, she is not eligible for the benefits of specialization.” The only citation to 

authority for this proposition, without explanation, is Collinsville Community Unit School 

District No. 10 v. Regional Board of School Trustees, 218 Ill. 2d 175, 181 (2006). After 

reviewing Collinsville, we are unsure of how it relates to this case, as it is a case about the 

failure of a school district to name and serve city residents as defendants. 

¶ 84 However, we find that the ALJ considered the proper factors in determining whether 

Fatima was eligible for specialization. The Code states that DCFS shall provide specialized 

foster care services for a child who requires such services due to emotional, behavioral, 

development, or medical needs, or any combination thereof, or any other needs which require 

special intervention services. 89 Ill. Adm. Code 301.90(b) (2010). The Code further states that 

a child’s eligibility for specialized foster care services shall be determined based upon the 

recommendation of CAYIT. 89 Ill. Adm. Code 301.90(b)(1)(B) (2010). There is no dispute 

that CAYIT held a staffing on October 18, 2010, and as a result denied Melanie B.’s request for 

specialization. The Code then gives examples of medical and behavioral conditions that could 

warrant specialization, as discussed above, and then lists the four factors that should be used in 

assessing whether a child with a described condition requires specialized foster care services. 

89 Ill. Adm. Code 301.90(b)(4) (2010). One of the factors is the “child’s current or 

recommended involvement in identified services,” and another factor is the child’s degree of 

need as defined by the intensity and frequency of services. Id. Accordingly, the Illinois 

Administrative Code specifically indicates that current foster care services should be 

considered in deciding whether Fatima is eligible for specialized services, and thus we cannot 

find that the ALJ’s consideration of these services was legally erroneous.

¶ 85 Arbitrary and Capricious 

¶ 86 Plaintiff’s final argument on appeal, that the ALJ’s decision was arbitrary and capricious in 

that it imposed requirements for eligibility beyond those in the DCFS rules, must also fail for 

the same reasons stated above. The ALJ properly considered the necessary factors in 

concluding Fatima was ineligible for specialization. 

¶ 87 CONCLUSION 

¶ 88 For the foregoing reasons, we affirm the judgment of the circuit court of Cook County 

upholding the decision of the Director. 

¶ 89 Affirmed.