child's best interest, and (2) parental fault exists. NRS 128.105 (1999) 

(amended 2015); In re Parental Rights as to A.L., 130 Nev., Adv. Op. 91, 

337 P.3d 758, 761 (2014). The district court found that terminating 

appellants' parental rights was in E.W.'s best interest and found three 

parental fault grounds: parental unfitness, failure of parental adjustment, 

and risk of serious injury to E.W. if returned to appellants' home. See 

NRS 128.105(2)(c)-(e) (1999) (amended 2015). Appellants argue that their 

case plans and the services provided to them by respondent did not 

account for their cognitive delays, and thus, their failure to complete their 

case plans, make behavior changes, and reunify with E.W. were not 

grounds to terminate their parental rights. Having considered the parties' 

arguments and reviewed the record, we conclude that the district court 

correctly applied the law, and substantial evidence supports the district 

court's factual findings. See A.L., 130 Nev., Adv. Op. 91, 337 P.3d at 761 

(providing that this court reviews the district court's findings of fact for 

substantial evidence, and questions of law de novo). 

Substantial evidence supports the district court's finding of 

parental fault. As to parental unfitness, testimony established that E.W. 

was diagnosed with failure to thrive while in appellants' care and medical 

causes of this condition were ruled out. Appellants did not display 

appropriate recognition of E.W.'s hunger cues and when E.W. was 

removed from appellants' home his weight had become so low for his age 

that it no longer appeared on an infant growth chart. Additionally, 

appellants were unable even together to exhibit appropriate parenting 

after E.W. was removed. For example, Jennifer was aggressive toward the 

child during visits, and Michael was passive toward the child and Jennifer 

and was unable to correct Jennifer when she demonstrated inappropriate 

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parenting, such as improper feeding. This evidence supports the district 

court's determination that appellants failed to provide E.W. with proper 

care and were unfit parents. See NRS 128.105(2)(c) (1999) (amended 

2015); NRS 128.106(1) (2013) (amended 2015) (providing that when 

determining parental fitness, a court shall consider any mental deficiency 

that "renders the parent consistently unable to care for the immediate and 

continuing physical or psychological needs of the child"); NRS 128.018 

(defining parental unfitness). 

The district court's finding that appellants failed to adjust is 

also supported by substantial evidence.' See NRS 128.105(2)(d) (1999) 

(amended 2015). Appellants did not meet their case plan objectives, and 

testimony established that appellants did not make behavior changes 

necessary to provide proper care for E.W. Moreover, two children 

previously living in appellants' home had been diagnosed with failure to 

thrive and removed by respondent, but appellants were not able to admit 

or recognize the nutritional deficiency that led to the failure-to-thrive 

diagnosis and the safety threat the children faced as a result of 

insufficient nutrition and care. The testimony regarding appellants' 

inability to make behavior changes, complete their case plans, and 

demonstrate a sufficient understanding of these children's failure-tothrive conditions supports the district court's finding of appellants' failure 

to adjust. 2NRS 128.0126 (stating that failure of parental adjustment 

1To the extent appellants argue that the district court improperly 

made findings regarding appellants' previous experience with respondent 

based on hearsay, we conclude that this argument lacks merit. 

2Because substantial evidence supports the district court's failure-toadjust findings, it is immaterial to the outcome of this appeal that the 

continued on next page... 

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occurs when a parent is unable to substantially correct "the circumstances, 

conduct or conditions which led to the placement of their child outside of 

their home"); see In re Parental Rights as to A.P.M., 131 Nev., Adv. Op. 66, 

P.3d (2015) (holding that "a completed case plan does not 

prohibit the district court from terminating parental rights if termination 

is otherwise warranted"). 

Substantial evidence also supports the district court's third 

finding of parental fault: a risk of serious physical injury to E.W. if he 

were to be returned to appellants' home. See NRS 128.105(2)(e) (1999) 

(amended 2015). Testimony established that E.W. failed to thrive in 

appellants' care prior to removal and that appellants had failed to adjust 

their behavior to consistently display appropriate parenting. NRS 

128.013(c), (d) (providing that "injury" to a child's health occurs when a 

parent neglects to provide the child proper subsistence, or fails to provide 

the child adequate care). 

Appellants additionally argue that terminating their parental 

rights was not in E.W.'s best interest. NRS 128.109(2) (1999) (amended 

2015) provides that when a child is removed from the home under NRS 

Chapter 432B and resides out of the home for 14 of 20 consecutive months, 

a court must presume that terminating the parental rights serves the 

child's best interest. Appellants contend that applying the best-interest 

presumption under NRS 128.109(2) is unfair because respondent failed to 

develop an appropriate case plan tailored to appellants' needs and 

contributed to the time lapse that triggered the presumption. NRS 

...continued 

district court declined to apply the evidentiary presumption provided by 

NRS 128.109(1)(b) (1999) (amended 2015). 

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Gibbons Pickering 

128.109(3), however, states that the NRS 128.109(2) presumption "must 

not be overcome or otherwise affected by evidence of failure of the State to 

provide services to the family." NRS 128.109(3) (1999) (amended 2015). 

Additionally, appellants did not provide sufficient evidence that additional 

services could bring about reunification within a reasonable time. NRS 

128.107(4). Finally, substantial evidence supports the district court's 

findings that E.W. was placed with an experienced and stable foster 

family, with whom E.W. is well bonded, and thus, terminating appellants' 

parental rights is in E.W.'s best interest. 

Accordingly, we 

ORDER the judgment of the district court AFFIRMED. 3 

cc: Hon. Deborah Schumacher, District Judge, Family Court Division 

Legal Aid Center of Southern Nevada, Inc. 

Hutchison & Steffen, LLC 

Washoe County District Attorney 

Washoe District Court Clerk 

3The district court found appellants had rebutted the NRS 

128.109(1)(a) (1999) (amended 2015) presumption regarding token efforts, 

however, because only one parental fault ground is required to terminate 

parental rights under NRS 128.105(2) (1999) (amended 2015), the absence 

of token efforts does not affect the outcome of this case. 

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