In re J.M.
Opinion
IN THE COURT OF APPEALS OF OHIO SIXTH APPELLATE DISTRICT
HURON COUNTY
In re J.M., D.M. Court of Appeals No. {39}H-25-028 {39}H-25-029
Trial Court No. DNA 2025 038 DNA 2025 039
DECISION AND JUDGMENT
Decided: September 4, 2026
*****
Richard H. Palau, for appellee.
W. Alex Smith, for appellant.
*****
DUHART, J.
{¶ 1} This is a consolidated appeal filed by appellant, K.M. (“father”), from the November 14, 2025 judgment of the Huron County Court of Common Pleas, Juvenile Division. The trial court found J.M. and D.M., the twin sons of father and his wife, E.M. (“mother”), dependent, and granted temporary custody of the twins to the Huron County Department of Job and Family Services (“the agency”). For the reasons that follow, we affirm the trial court’s judgment.
{¶ 2} Father1 sets forth five assignments of error:
1. The trial court’s adjudication of the minor children as dependent under R.C. 2151.04(C) was against the manifest weight of the evidence and unsupported by clear and convincing evidence.
2. The trial court committed reversible error at the adjudicatory hearing by admitting and relying upon inadmissible hearsay to establish the children’s “condition or environment” in violation of the Sixth District’s standard in State v. Kamer.
3. The trial court erred in permitting lay social workers to provide specialized medical testimony regarding the children’s “prognosis” and medical “necessity” in violation of Evid.R. 702.
4. The trial court abused its discretion at the dispositional stage by adopting a case plan requirement for a full psychological evaluation to assess “competency” without a demonstrated nexus to the reasons for removal.
5. The trial court erred in f[i]n[]ding that the [a]gency made “reasonable ef[f][]orts” to prevent continued removal when the [a]gency referred parents to services with known waitlists and failed to mitigate state imposed logistical barriers.
Background
August 6 through August 29, 20252
{¶ 3} Father and mother live in Huron County, Ohio. Their twins were born on August 6, 2025, and both twins suffer from severe medical issues. J.M. has a rare, serious skin disorder and D.M. has a condition in which his esophagus is not connected,
1 Mother did not appeal the trial court’s judgment.
2 There are discrepancies in the record as to when certain events happened, but the record is clear that the events occurred between the August 6 to August 29, 2025 time period.
so he requires a feeding tube, future surgery and extended long-term care. Father himself had surgery on his abdomen in early August 2025.
{¶ 4} Shortly after D.M. was born, he was admitted to the Neonatal Intensive Care Unit (“NICU”) at Akron Children’s Hospital (“Akron”). A medical social worker (“social worker”) at Akron NICU became involved with the family. Her job responsibilities consisted of making reports to the agency and coordinating children’s discharge plans with the agency and providing support and resources to families with children with long- term NICU admissions. The social worker made a referral to the agency based on concerns she had observed including that parents had very limited visits with D.M.; she recalled seeing parents two times between August 7 and 29, 2025. It was important for parents to visit D.M. in the NICU so they could be involved with D.M.’s care and treatment so they could obtain proper medical information and training in every aspect of the baby’s care to ensure D.M. could eventually be safely discharged to parents.
{¶ 5} Medical professionals informed an agency worker (“the agency worker”)
that due to the lack of visits and human interaction, D.M. developed a negative response to people because the only interaction he had was when he was poked and prodded. D.M. remained in Akron’s NICU throughout the trial court proceedings.
{¶ 6} J.M. was taken to the emergency room (“ER”) at Shelby Hospital by parents because J.M. was vomiting, crying and in distress. During J.M.’s medical treatment, a nurse was concerned that J.M. was in a onesie with no blanket despite it being a cooler day and even cooler in the hospital. The nurse was also troubled that parents did not bring a diaper bag for J.M. so they did not have a bottle or diapers and neither parent attempted to interact with or console J.M., who had been crying for 25 to 30 minutes; mother said she did not want J.M. to get used to being held. The nurse asked parents if J.M. took a pacifier and they indicated he did and there was one in the car, but neither parent went to retrieve it. The nurse wrapped J.M. up in a warmed blanket and held him until he calmed down. The nurse left J.M. with parents for a few minutes and when the nurse came back, J.M. was crying and fussing, but neither parent was paying attention to him. The nurse kind of demanded that mother or father get the pacifier to help soothe J.M. The nurse then made a referral to the agency based on her fear that J.M. was not getting the care he needed from parents. The agency became involved and a safety plan was created. J.M. was discharged to paternal grandmother.
{¶ 7} The next morning, J.M. was taken to the Shelby Hospital ER by grandmother because he was vomiting and not eating. J.M. was transferred to Akron’s NICU, where he was admitted and treated for about one week. J.M. was discharged to grandmother and neither parent was present in the NICU at that time. A week or so later, J.M. was treated at Akron’s burn center due to a severe burn that he sustained in his “lower private region” when he was with parents. J.M. was admitted to Akron’s burn unit overnight, then discharged.3 A few days later, J.M. was again admitted to Akron’s NICU. Although the burn unit staff did not make a referral to the agency, the NICU medical team believed J.M.’s wounds were not consistent with the explanation provided by parents.
3 It appears that J.M. was discharged to parents.
{¶ 8} Several days later, J.M. was admitted to Akron’s NICU a third time. The social worker made a formal referral to the agency due to concerns about J.M.’s multiple NICU admissions within a short period of time (three admissions between August 7 and 29, 2025), parents’ lack of involvement and engagement with J.M. and mother having canceled a burn unit follow-up appointment and a dermatologist appointment for J.M. against the advice of J.M.’s treatment team. J.M. was discharged to grandmother.
{¶ 9} With respect to both twins, parents were not willing to be present for treatment, despite instructions from medical providers that parents attend and participate. The staff at Akron’s encouraged parents to stay at the hospital while the twins were being treated, as Akron has private rooms which could accommodate the twins and parents. Staff also informed parents that they could stay at the Ronald McDonald House, which was adjacent to Akron, at no cost. Nevertheless, parents declined to stay with the twins. Staff also offered gas vouchers and insurance referrals to parents to help alleviate the travel costs between Huron County and Akron, but parents declined those offers too.
{¶ 10} When the agency initiated the case, an on-call worker (“the on-call worker”) met with parents. A safety plan with grandmother was discussed and parents agreed to do the safety plan for only one night.
{¶ 11} The next day, the case was handed off to the agency worker, who contacted grandmother. While on the phone, grandmother relayed that J.M. was turning blue around his mouth, vomiting and not breathing. Grandmother hung up and called 911. J.M. was taken to Shelby Hospital, then transferred to Akron’s NICU.
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IN THE COURT OF APPEALS OF OHIO SIXTH APPELLATE DISTRICT
HURON COUNTY
In re J.M., D.M. Court of Appeals No. {39}H-25-028 {39}H-25-029
Trial Court No. DNA 2025 038 DNA 2025 039
DECISION AND JUDGMENT
Decided: September 4, 2026
*****
Richard H. Palau, for appellee.
W. Alex Smith, for appellant.
*****
DUHART, J.
{¶ 1} This is a consolidated appeal filed by appellant, K.M. (“father”), from the November 14, 2025 judgment of the Huron County Court of Common Pleas, Juvenile Division. The trial court found J.M. and D.M., the twin sons of father and his wife, E.M. (“mother”), dependent, and granted temporary custody of the twins to the Huron County Department of Job and Family Services (“the agency”). For the reasons that follow, we affirm the trial court’s judgment.
{¶ 2} Father1 sets forth five assignments of error:
1. The trial court’s adjudication of the minor children as dependent under R.C. 2151.04(C) was against the manifest weight of the evidence and unsupported by clear and convincing evidence.
2. The trial court committed reversible error at the adjudicatory hearing by admitting and relying upon inadmissible hearsay to establish the children’s “condition or environment” in violation of the Sixth District’s standard in State v. Kamer.
3. The trial court erred in permitting lay social workers to provide specialized medical testimony regarding the children’s “prognosis” and medical “necessity” in violation of Evid.R. 702.
4. The trial court abused its discretion at the dispositional stage by adopting a case plan requirement for a full psychological evaluation to assess “competency” without a demonstrated nexus to the reasons for removal.
5. The trial court erred in f[i]n[]ding that the [a]gency made “reasonable ef[f][]orts” to prevent continued removal when the [a]gency referred parents to services with known waitlists and failed to mitigate state imposed logistical barriers.
Background
August 6 through August 29, 20252
{¶ 3} Father and mother live in Huron County, Ohio. Their twins were born on August 6, 2025, and both twins suffer from severe medical issues. J.M. has a rare, serious skin disorder and D.M. has a condition in which his esophagus is not connected,
1 Mother did not appeal the trial court’s judgment.
2 There are discrepancies in the record as to when certain events happened, but the record is clear that the events occurred between the August 6 to August 29, 2025 time period.
so he requires a feeding tube, future surgery and extended long-term care. Father himself had surgery on his abdomen in early August 2025.
{¶ 4} Shortly after D.M. was born, he was admitted to the Neonatal Intensive Care Unit (“NICU”) at Akron Children’s Hospital (“Akron”). A medical social worker (“social worker”) at Akron NICU became involved with the family. Her job responsibilities consisted of making reports to the agency and coordinating children’s discharge plans with the agency and providing support and resources to families with children with long- term NICU admissions. The social worker made a referral to the agency based on concerns she had observed including that parents had very limited visits with D.M.; she recalled seeing parents two times between August 7 and 29, 2025. It was important for parents to visit D.M. in the NICU so they could be involved with D.M.’s care and treatment so they could obtain proper medical information and training in every aspect of the baby’s care to ensure D.M. could eventually be safely discharged to parents.
{¶ 5} Medical professionals informed an agency worker (“the agency worker”)
that due to the lack of visits and human interaction, D.M. developed a negative response to people because the only interaction he had was when he was poked and prodded. D.M. remained in Akron’s NICU throughout the trial court proceedings.
{¶ 6} J.M. was taken to the emergency room (“ER”) at Shelby Hospital by parents because J.M. was vomiting, crying and in distress. During J.M.’s medical treatment, a nurse was concerned that J.M. was in a onesie with no blanket despite it being a cooler day and even cooler in the hospital. The nurse was also troubled that parents did not bring a diaper bag for J.M. so they did not have a bottle or diapers and neither parent attempted to interact with or console J.M., who had been crying for 25 to 30 minutes; mother said she did not want J.M. to get used to being held. The nurse asked parents if J.M. took a pacifier and they indicated he did and there was one in the car, but neither parent went to retrieve it. The nurse wrapped J.M. up in a warmed blanket and held him until he calmed down. The nurse left J.M. with parents for a few minutes and when the nurse came back, J.M. was crying and fussing, but neither parent was paying attention to him. The nurse kind of demanded that mother or father get the pacifier to help soothe J.M. The nurse then made a referral to the agency based on her fear that J.M. was not getting the care he needed from parents. The agency became involved and a safety plan was created. J.M. was discharged to paternal grandmother.
{¶ 7} The next morning, J.M. was taken to the Shelby Hospital ER by grandmother because he was vomiting and not eating. J.M. was transferred to Akron’s NICU, where he was admitted and treated for about one week. J.M. was discharged to grandmother and neither parent was present in the NICU at that time. A week or so later, J.M. was treated at Akron’s burn center due to a severe burn that he sustained in his “lower private region” when he was with parents. J.M. was admitted to Akron’s burn unit overnight, then discharged.3 A few days later, J.M. was again admitted to Akron’s NICU. Although the burn unit staff did not make a referral to the agency, the NICU medical team believed J.M.’s wounds were not consistent with the explanation provided by parents.
3 It appears that J.M. was discharged to parents.
{¶ 8} Several days later, J.M. was admitted to Akron’s NICU a third time. The social worker made a formal referral to the agency due to concerns about J.M.’s multiple NICU admissions within a short period of time (three admissions between August 7 and 29, 2025), parents’ lack of involvement and engagement with J.M. and mother having canceled a burn unit follow-up appointment and a dermatologist appointment for J.M. against the advice of J.M.’s treatment team. J.M. was discharged to grandmother.
{¶ 9} With respect to both twins, parents were not willing to be present for treatment, despite instructions from medical providers that parents attend and participate. The staff at Akron’s encouraged parents to stay at the hospital while the twins were being treated, as Akron has private rooms which could accommodate the twins and parents. Staff also informed parents that they could stay at the Ronald McDonald House, which was adjacent to Akron, at no cost. Nevertheless, parents declined to stay with the twins. Staff also offered gas vouchers and insurance referrals to parents to help alleviate the travel costs between Huron County and Akron, but parents declined those offers too.
{¶ 10} When the agency initiated the case, an on-call worker (“the on-call worker”) met with parents. A safety plan with grandmother was discussed and parents agreed to do the safety plan for only one night.
{¶ 11} The next day, the case was handed off to the agency worker, who contacted grandmother. While on the phone, grandmother relayed that J.M. was turning blue around his mouth, vomiting and not breathing. Grandmother hung up and called 911. J.M. was taken to Shelby Hospital, then transferred to Akron’s NICU.
{¶ 12} That same day, parents came into the agency and met with the agency worker. Parents were very upset about the on-call worker’s visit and parents advised the agency worker that they did not want agency involvement. The agency worker mainly spoke with mother because when the agency worker tried to talk to father, he growled at her. The agency worker spoke with grandmother again and learned that J.M. was being admitted once more to Akron’s NICU. J.M. was discharged to grandmother two or three days later.
{¶ 13} The agency worker explained that the case was transferred to juvenile court due to concerns with the parents and their behavior, like canceling necessary medical needs (J.M.’s medicine) and appointments for J.M. and failing to interact with the twins.
{¶ 14} On August 29, 2025, the shelter care hearing was held. The agency recommended that grandmother be granted temporary custody; the trial court granted grandmother temporary custody of the twins.
{¶ 15} That same day, the agency filed complaints alleging that J.M. and D.M.
were dependent children, pursuant to R.C. 2151.04(C). October 6, 2025
{¶ 16} The Family Case Plan (“case plan”) was filed by the agency. The following information set forth in the case plan is relevant to father’s appeal.
...
[J.M.] . . . [D.M.]4
4 The same information is set forth for J.M. and D.M. and will therefore not be repeated.
Permanency Goal: Return the child(ren) to parent/guardian/or custodian (Reunification)
Agency Legal Status: Temporary Custody/Placement and Care Child Location: Certified Foster Home ...
1. What are the concerns/needs for the family?
[Father] struggles to be an active father and bond with the boys, understand their serious medical needs, be prepared for anything the children may need and how to care for them.
2. What does the family and Worker want to see happen to address the identified concerns/needs?
For [father] to understand that the boys need him to be an active father, attend to their medical needs, be able to care for them in a safe, appropriate manner and bond with the boys.
3. What is causing these concerns/needs for the family?
The infant[]s[’] self[-]protection. [Father’s] response to stressors, cognitive abilities to understand his children’s needs, parenting practices and mental health.
4. What strengths and family/community supports does the family have?
The family has a home and [father] is employed. They have extended family for support and are connected to community supports.
5. What steps will the family take to achieve what the Family and Caseworker want to see happen? Identify the individuals who will complete these action steps. (Services to address the concerns/needs)
[Father] will fully participate in the intake and assessment process for mental health concerns.
[Father] will complete a Psychological Evaluation.
[Father] will follow all recommendations of these assessments.
[Father] will be fully engaged in treatment until he is discharged successfully as determined by the service provider.
[Father] will complete a parenting program(s) and attend all classes.
Parenting education will be specific to [J.M.] and [D.M.’s] age, development, and unique needs.
[Father] will actively participate in all visits with [J.M.] and [D.M.].
[Father] will not use his phone or any electronics during visits.
[Father] will attend all appointments for [J.M.] and [D.M.].
[Father] will provide safe, sanitary, stable housing for himself and his family.
[Father] will obtain and maintain employment so he can provide financially for his family.
[Father] will sign all releases of information as requested by the service provider and the agency.
[Father] will allow Agency staff access to his home for all scheduled and unscheduled face[-]to[-]face visits.
...
6. How will the family’s progress be measured?
Progress will be measured by treatment providers progress reports, by observing visits, family and by Caseworkers[’] observations during home visits.
7. When will the family’s progress be reviewed?
Progress will be reviewed informally through monthly home visits and phone calls and formally every three months at case reviews and semiannual reviews.
...
[J.M.] . . . [D.M.]
...
Best Interest /Special Needs Consideration for Child[’s] Location How was it determined this was a safe and appropriate environment for the child?
The placement is a certified foster home that is close to Akron Children’s and is able to provide the special care needed for the boys. The foster family has supports so that they are able to have frequent visits and contact with [D.M] while he remains hospitalized.
How will the Child[’s] Location meet the best interest of the child?
The foster parents are able to visit with [D.M.] while at Akron Children’s almost daily and take [J.M.] there to be with his brother as well.
How will the Child[’s] Location meet the special needs of the child?
The foster home can and will be able to . . . meet all the boys[’] needs being close to Akron and with their specialized training[.]
How will the Child[ren’s] Location meet the [case plan] [g]oals of the Child[ren]?
The children will be able to get the medical treatment needed for their special conditions.
What is the proximity of the Child[ren’s] Location to the parent, guardian, custodian? What transportation problems might create obstacles to visitation? How will the agency resolve these obstacles?
The boys are placed 2 hours from the parents. The foster parents/parents will meet for visits. The agency can provide gas vouchers.
...
November 13, 2025
{¶ 17} The adjudicatory hearing was held. Those in attendance included parents, the agency worker, a nurse from Shelby Hospital, the social worker and the twins’ guardian ad litem (“GAL”). The agency worker, the nurse and the social worker testified after which the trial court found the conditions and environment from August 6 through 29, 2025, justified the agency’s intervention. The court further found the twins were dependent, citing “being new parents,” the “high needs of the children” and “father’s recent surgery.” November 14, 2025
{¶ 18} The court issued its judgment entry which provides in relevant part:
These cases came before the [c]ourt on 13 November 2025 for an adjudicatory hearing on Complaints filed by the [agency] alleging that twin infants . . . were Dependent Children pursuant to R.C. 2151.04(C). . .
Following the presentation of evidence, the [c]ourt makes the following findings of fact and conclusions of law. Twins . . . were born on 6 August 2025. . . After birth, both soon began to exhibit concerning symptoms that led to hospitalization. While receiving medical treatment, a nurse at a hospital in Shelby, and a social worker at Akron Children’s Hospital both made referrals to [the agency] based on their concerns that the children’s parents were not responding appropriately to the children’s acute medical conditions.
...
[The court set forth the events which occurred August 6 through 29, 2025, and which we summarized above.]
Based on the foregoing, the [c]ourt finds clearly and convincingly that the conditions and environment of [the twins] after their birth through 29 August 2025 warranted the agency, in the interest of the children, in assuming their guardianship and otherwise mandating necessary measures to ensure their safety. [Parents] were not appropriately engaged in the necessary treatment of their children’s acute medical conditions, did not comply with treatment recommendations and cancelled necessary appointments. The [c]ourt therefore clearly and convincingly finds that [the twins] are Dependent Children as defined by R.C. 2151.04(C).
...
Thereupon the [c]ourt [finds] that the [agency] made all reasonable efforts to prevent the placement and that placement outside the home of . . .
[]parents[] is in the best interest of the children and that the children’s placement is in the most family-like and least-restrictive setting available and in close proximity to the parents’ home, consistent with the best interest and special needs of the children.
The [c]ourt [finds] that reasonable efforts to prevent removal were not made by the [agency] because the minor children were removed during an emergency in which the children could not safely remain at home.
The [c]ourt [finds] that the children’s parents are currently unfit or unsuitable for temporary custody because both currently lack the capacity to appropriately respond to the twin newborns’ acute medical needs.
...
It is further ORDERED, ADJUDGED and DECREED that . . .
mother is granted supervised visitation with said children at the [agency] or supervised by persons approved by the [agency] at locations approved by the [agency] as arranged between mother and the [agency].
It is further ORDERED, ADJUDGED and DECREED that . . . father is granted supervised visitation with said children at the [agency] or supervised by persons approved by the [agency] at locations approved by the [agency] as arranged between father and the [agency].
...
November 20, 2025
{¶ 19} The dispositional hearing was held. In attendance were, inter alia, parents, the agency worker, on-going agency caseworker (“the caseworker”) and GAL. The witness testimony is summarized below. The Agency Worker
{¶ 20} The agency worker testified about events which occurred after August 29, 2025. She testified that on September 12, 2025, grandmother called and said J.M. was not waking up and was very limp. The agency worker advised grandmother to take J.M. to the hospital if it was an emergency. Grandmother took J.M. to Fisher-Titus Hospital where it was determined that his blood sugar was very low; J.M. was sent to Akron for treatment. Mother went with grandmother and J.M. to Akron. While at Akron, grandmother called the agency worker and said she was no longer able to provide care for J.M. and his needs. After J.M. was discharged from Akron, grandmother and mother took him to the agency where an ex parte proceeding was held to place J.M. in the agency’s care. In order for the agency worker to have J.M. prepared for his foster placement, she asked mother and grandmother routine questions, like the last time J.M. ate and if they had formula or diapers. They gave the agency worker formula in a salsa can, but when asked, they did not know how much formula was in the can. They were also asked about J.M.’s feeding routine, like how many ounces he was taking and how often, but they changed their story multiple times and showed a lack of understanding of when he ate last and how much he was eating on a regular basis.
{¶ 21} On September 16, 2025, the agency worker went with the family to a dermatology appointment for J.M. during which she observed parents, as she was supervising that contact. Father did not pick up J.M. and had very limited interaction with the baby. At the end of the appointment, parents were asked if they wanted to put J.M. in the carrier, but they did not know how to buckle him in and asked the agency worker for help. While walking out to the agency worker’s car, J.M. got fussy so parents took him out of the carrier. At the car, parents were again asked if they wanted to place J.M. back in the carrier. Parents were able to sit J.M. in the carrier but did not know how to buckle him in or fasten the carrier into place in the car.
{¶ 22} With respect to D.M., a hearing was held on or about September 16, 2025, to ask that D.M. come into care as well. There were concerns, after speaking with multiple hospital staff, that parents were still continually not visiting D.M., and D.M. was at the point where he had not bonded with anyone, which could lead to issues as he got older. The agency wanted someone to start to create a bond with D.M. and offered assistance to parents such as gas vouchers, hospital services like the Ronald McDonald House and working with grandmother to see if parents could ride with her.
{¶ 23} The agency worker completed a family assessment and there were some safety risk factors such as parenting practices, which is essentially how the parents interact as a whole with their children, and mental health for both parents. Mother had some mental health history as a child and was really never able to get the care she needed from the custodian with whom she was placed. After giving birth to the twins, mother said she had postpartum depression and was on medication and was looking to get into counseling services. The agency worker offered to help mother with a referral if needed. The reason for the agency worker’s risk assessment contributor for father was that he would not communicate with her, and she did not know if he just did not want to communicate, if it was a mental health diagnosis or if he had a cognitive delay. Even at the dermatology appointment, father did not ask any follow-up questions to the doctors who explained J.M.’s skin condition diagnosis, regarding what that would look like lifelong. The agency worker did not know what the barrier was with father, but she wanted to try to overcome it and work toward the case plan goal.
{¶ 24} On September 19, 2025, the agency worker took J.M. to his foster care placement in Youngstown and shortly thereafter, an agency caseworker came in to do the hand-off and provide services.
{¶ 25} Prior to foster placement, grandmother was the supervisor of parents’ visits with the twins and there were no time limits for visits. After placement, parents’ supervised visits were limited to one two-hour visit per week. The safety risk of parents having unsupervised interaction with D.M. in the NICU was that D.M. has a lot of wires and tubes on him, which can make it challenging to pick him up, change his diaper and provide for his basic needs. The hospital staff educated parents numerous times on how to handle D.M. but there were still concerns that parents were not able to appropriately handle the baby. The agency worker also received the same education as parents, and she thought it would be very easy to handle D.M. once you learn how to do it and apply those practices.
The Caseworker
{¶ 26} The caseworker then testified to the following. The agency continued supervised visits because parents struggled to bond with the boys, mother struggled to change diapers appropriately (father did not usually change diapers), father struggled to participate in visits - mother had to prompt him - but he still did very little, mother struggled with burping J.M. after his pace feedings5 and parents struggled to hold the twins appropriately. Father adjusted D.M.’s G-tube (feeding tube) when he put the baby up on his shoulder to hold him. When the tube was adjusted, it made D.M. bleed, and he was in a lot of pain. In addition, parents got very frustrated during visits and tended to leave early and on one occasion, medial staff told parents to wash their hands before a visit, but they resisted (father worked at a tire business). Parents also responded inappropriately when the twins were in distress or in pain by laughing instead of being concerned about what was wrong or trying to soothe them and leaving the visit early.
{¶ 27} Parents had the ability to attend the twins’ medical appointments and per the case plan, parents were asked to go to all of the appointments, so they could stay informed about the twins’ medical needs. D.M. had a very major surgery a few days before the dispositional hearing, but parents did not show for it; they called the night before stating they did not feel well. D.M. had another surgery scheduled for the day after the hearing on his stomach and esophagus.6 D.M. was struggling; his lung collapsed
5 J.M.’s pace feedings require that he is fed some, he is given a break, burped, and then fed again because he struggles with his digestion. 6 D.M.’s stomach and esophagus were whip-stitched, trying to pull them together.
and the tubing in his lung was bleeding. D.M. was very uncomfortable and in a lot of pain.
{¶ 28} The agency had concerns for mother and father’s mental health, as mother had a history of self-harming and father had a history of not complying with case plans on other cases.
{¶ 29} Mother’s case plan requirements included fully participating in the intake and assessment process for mental health concerns, completing a psychological evaluation and parenting education programs. Parenting programs were offered to the parents at the hospital regarding how to take care of D.M., but otherwise, parents did not engage in programing although it was suggested to mother, the month before, that she and father go to Abigail Pregnancy Center due to the age of the twins. The caseworker did not make a referral for those services, rather, she gave mother the information and the phone numbers so mother could set up appointments for times convenient for mother and father.
{¶ 30} The caseworker treated parents like any other family with respect to their case plan services - she explained what was expected of them, gave them places where they could go and she always asked if parents had any questions or if they needed help with anything. She noted that mother picked Firelands for counseling.
{¶ 31} The twins’ medical conditions were a lot and there was extensive medical information. At surgery appointments, parents were able to ask the surgeons questions, and for other general questions, parents were to contact Akron’s social worker, who provided information to parents when they called, or they could ask the agency.
The GAL
{¶ 32} The GAL testified she was assigned to J.M. and D.M. at the initial shelter care hearing. She believed parents should have supervised visitation with the twins due to concerns she observed. For example, on November 10, 2025, the GAL was at a hospital visit and J.M. cried excessively while father held him. Father was unable to soothe J.M., but made some attempts, with prompting, to adjust how he was holding and feeding the baby. Mother suggested that she hold J.M., but that never occurred. Parents could not figure out how to transfer the twins amongst themselves, so the GAL suggested parents could lay either or both of the twins in the crib if they wanted; mother seemed thankful for that suggestion. Eventually, J.M. was screaming so inconsolably that the GAL felt his distress was harmful, so she asked if foster dad could hold J.M. Father was very amenable and immediately passed the baby to the foster dad, who soothed J.M. in less than a minute. The GAL did not know how either parent would have been able to soothe J.M. if they were not supervised. The GAL left the visit about 25 minutes early and later learned that parents left shortly after she did. Thereafter, the GAL spoke with a supervisor about the possibility of having in-person, hands-on parenting classes with parents at the hospital; the supervisor explored securing those classes soon.7
7 The caseworker, when asked by the judge after the GAL’s testimony, confirmed that the agency reached out to Help Me Grow for in-person parenting classes at Akron, in Summit County, and parents were on the wait list; there was no indication of the timeline on the wait list. The caseworker also explained that when the twins were back in Huron County, Help Me Grow in that county could conduct parenting classes.
{¶ 33} The GAL also requested that parents have some visits separate from each other to gauge each parent’s abilities and needs, like 15 minutes or a half hour for each parent. The GAL hoped that individual parenting instruction could occur during that time. The GAL thought father was very reliant on mother to do most of the things, and the GAL did not know if he just wanted mother to do things first or if he was capable of doing things. The GAL thought it was important to know each parent’s independent parenting skills to determine if one parent could provide care for both twins.
{¶ 34} The GAL found parents receptive to suggestions on parenting skills. In one instance, father made efforts to follow multipart recommendations, but he may have gotten lost after the first or second part of the recommendation.
{¶ 35} Parents’ visits with the twins occurred once a week for two hours, yet parents cancelled some visits. Parents did not attend all of the medical appointments for the twins. Just before the hearing, D.M. had a very serious surgery and was under anesthesia for more than four hours but neither parent was present for the surgery.
{¶ 36} The GAL heard that parents said they did not want the twins to become accustomed to being held all of the time, but she never heard them say that. However, parents were informed multiple times of the error in the theory of letting babies cry it out and not letting babies get used to always being held. Conclusion of the Hearing
{¶ 37} The agency requested that the court approve the case plan and continue the current orders. Parents requested that visitation be expanded, with the approval of the agency and the GAL, as far as frequency, time, even from eyes on to eyes off supervised visits as parents have shown growth and they are learning. In addition, father objected to the requirement of a full psychological evaluation. Trial Court’s Findings
{¶ 38} The judge addressed the parents, and stated:
Parents, I definitely want you to be able to see your children. It definitely needs to be supervised at this point in time. And I, you know, I’ve picked up during the course of the Adjudicatory Hearing and today, that there have been significant efforts to get you . . . up to Akron to be able to have regular consistent contact with your children.
You need to take advantage of every one of those opportunities.
Don’t leave early. There is another procedure coming up tomorrow. You need to be there. And . . . you’re going to demonstrate through your actions much more than your words whether or not you’re committed to your children.
And significant surgeries like the one I just heard about, where your son was under anesthesia for four hours, there better be some monumental reason for you not being there.
...
And there are going to be other procedures like that. You need to be there. Your physical presence there is going to send a clear message to me one way or another. If you’re not there, it’s going to send a pretty big message too.
So your contact does need to be supervised. I haven’t put any judicial limitation on the duration of those visits or the frequency of those visits, but clearly, given what’s going on with each of them right now, there are some practical limitations that are necessitated by the medical conditions at this point.
So you need to be observant of that. And as those improve, hopefully, there may be additional time that’s available for supervised visitation. Maybe some other places for that supervised visitation could occur. But you need to follow the, you know, the medical team’s recommendation about that, about where those visits can occur. And obviously the [agency] is going to have the discretion to identify who is the supervisor and where the supervision of those visits occurs.
I am open. There is going to be a further Dispositional Hearing set several months down the road. If improvements take place or request of change orders or more specificity with orders as we approach the holidays, anything like that, certainly the Court can address that, but the Court is going to be involved. The [agency] is not going to have discretion to just go to eyes-off supervision or eliminate supervision at all. Those requests need to come through the Court so all parties will have an opportunity to be heard before any decision like that is made.
I am going to adopt the Case Plan here today. I do see a distinction between a mental health assessment and psychological evaluation. I think there is some concern about competency, and whether or not there are some other services that might be necessary to enable you parents to fulfill the Case Plan objective, which right now is reunification. . .
But there are some elements above and beyond you just simply receiving some treatment for mental health conditions might have; there may be some . . . additional instructions, additional resources, additional services that might be necessary to put you in a position to be competent parents moving forward. And I think the psychological evaluation will be instructive to that particular issue.
...
{¶ 39} That same day, the court issued its judgment entry which provides in relevant part:
This cause came to be heard on November 20, 2025, for a dispositional hearing. . .
...
Thereupon the [c]ourt found that the [agency] made all reasonable efforts to prevent the placement and that placement outside the home of . . .
[]parents[] is in the best interest of the children and that the children’s placement is in the most family-like and least-restrictive setting available and in close proximity to the parents’ home, consistent with the best interest and special needs of the children.
The [c]ourt found that reasonable efforts to prevent removal were not made by the [agency] because the minor children were removed during an emergency in which the children could not safely remain at home.
The [c]ourt found that the children’s parents are currently unfit or unsuitable for temporary custody because both currently lack the capacity to appropriately respond to the twin newborns’ acute medical needs.
...
It is therefore ordered that [the twins] be committed to the temporary custody of the Director of the [agency] pending further hearing herein.
It is further ordered that . . . mother is granted supervised visitation with said child at the [agency] or supervised by persons approved by the [agency] at locations approved by the [agency] as arranged between mother and the [agency].
It is further ordered that . . . father is granted supervised visitation with said child at the [agency] or supervised by persons approved by the [agency] at locations approved by the [agency] as arranged between father and the [agency].
...
The [c]ourt having reviewed the case plan filed on October 06, 2025;
it is hereby ordered that the aforementioned be approved, and that all parties comply with the same.
...
Assignments of Error
{¶ 40} For ease of discussion, we will address father’s assignments of error out of order.
Second Assignment of Error
{¶ 41} Father argues that the trial court erred by admitting inadmissible hearsay at adjudication. He submits that at the adjudicatory hearing, the agency worker testified regarding D.M.’s psychological state as reported by hospital staff, “We were told by the medical professionals at Akron that [D.M.] had developed a response where every time a person would come touch him . . . it was a negative response because he was only being poked and prodded, never held . . .” Father contends that counsel objected, but the court admitted the statement “for that limited purpose” of explaining why the case was referred to the agency. Father asserts that this hearsay, alleging a lack of bonding, served as a substantive pillar for the court’s dependency finding. He maintains that if the State uses hearsay to “fill in the blanks” for witnesses who do not testify, it is prejudicial error.
{¶ 42} Father further argues that adjudicatory hearings require the strict application of the Rules of Evidence, and on appeal, the admission of hearsay is reviewed de novo because a trial court has “no discretion to admit hearsay.” Father cites to State v. Kamer, 2022-Ohio-2070, ¶ 172 (6th Dist.).
Standard of Review
{¶ 43} A trial court has discretion to determine which evidence to admit or exclude at trial, and such decisions will not be reversed on appeal absent an abuse of discretion. State ex rel. VanDyke v. Pub. Emp. Retirement Bd., 2003-Ohio-4123, ¶ 43. A trial court abuses its discretion if its evidentiary ruling is unreasonable, arbitrary, or unconscionable. Blakemore v. Blakemore, 5 Ohio St.3d 217, 219 (1983).
Law
{¶ 44} Hearsay is an out-of-court statement made by the declarant offered in evidence to prove the truth of the matter asserted. Evid.R. 801(C). A statement is not hearsay when offered for a purpose other than to prove the truth of the matter asserted, for instance, to show its effect on the listener. State v. Osie, 2014-Ohio-2966, ¶ 118, 122, citing State v. Davis, 62 Ohio St.3d 326, 343 (1991). Therefore, “‘testimony which explains the actions of a witness to whom a statement was directed, such as to explain the witness’ activities, is not hearsay.’” State v. LaMar, 2002-Ohio-2128, ¶ 59, quoting State v. Maurer, 15 Ohio St.3d 239, 262 (1984).
{¶ 45} If, however, a statement is hearsay, under Civ.R. 61, “[n]o error in either the admission or the exclusion of evidence . . . is ground for . . . vacating, modifying or otherwise disturbing a judgment or order, unless refusal to take such action appears to the court inconsistent with substantial justice.” Generally, to find substantial justice has been achieved to prevent reversal for errors which occurred at trial, an appellate court “must not only weigh the prejudicial effect of those errors but also determine that, if those errors had not occurred, the jury or other trier of the facts would probably have made the same decision.” Hallworth v. Republic Steel Corp., 153 Ohio St. 349 (1950), paragraph three of the syllabus. See also Hayward v. Summa Health Sys./Akron City Hosp., 2014-Ohio- 1913, ¶ 25; Schmidt v. Crayne, 2024-Ohio-4726, ¶ 137 (6th Dist.) (The “assignments of error require us to review the entire record in considering whether prejudicial error occurred. See Kirn v. Toth Buick-Opel, 1981 WL 3994, *2 (9th Dist. May 27, 1981), citing Civ.R. 61 . . .; Lourdes K. v. Gregory Q., 1997 WL 256681, *6 (6th Dist. May 16, 1997) (reviewing entire record and determining that error in admission of hearsay evidence was harmless).”).
Analysis
{¶ 46} Upon review of the agency worker’s testimony concerning D.M.’s psychological state and the matter for which the testimony was admitted, we find that it is clear the testimony was offered to show one of the reasons why the agency became involved with the family and was not offered to prove that D.M. developed a negative response to people touching him because he was not being held. Contrary to father’s assertion that the testimony was offered to allege a lack of bonding between him which served as a substantive pillar for the trial court’s dependency finding, the court specifically stated it admitted the testimony for the limited purpose of explaining why the case was referred to the agency. Thus, the testimony was not hearsay and was admissible, as it was offered to show the effect of the hospital staff’s statement (that, inter alia, D.M. had a negative response to touch because he was not being held) on the agency worker and her subsequent actions as a result of the statement (referring the case to the agency).
{¶ 47} Moreover, any error in admitting the agency worker’s testimony would be harmless as the social worker also testified that she made a referral to the agency based on concerns that parents were not visiting D.M., and there were other bases for the court’s dependency finding. Since there is ample evidence without the agency worker’s testimony to support the trial court’s conclusion that the twins are dependent, citing mother and father “being new parents,” the “high needs of the children” and “father’s recent surgery,” we find father’s second assignment of error is not well-taken.
Third Assignment of Error
{¶ 48} Father argues that the admission of lay medical opinions violated Evid.R.
702. He notes that expert testimony is required for matters beyond the knowledge of laypersons. He cites State v. Walls, 2020-Ohio-5446 (6th Dist.), in support.
{¶ 49} Father contends that the trial court permitted the social worker to testify at the adjudicatory hearing to a medical prognosis: “Q: And then what happens after that? Is everything okay right after that? A: No, things won’t be okay for a long time.” Father maintains that allowing a social worker to testify to the “life-threatening” nature of J.M.’s skin conditions and the long-term surgical prognosis of D.M.’s issues with his esophagus without expert qualification is reversible error in a case predicated entirely on medical complexity. He asserts that this testimony (“challenged testimony”) is impermissible because medical conclusions must be testified to by expert medical professionals. He submits that the agency did not qualify the social worker as a medical expert under Evid.R. 702. Lastly, he claims that allowing the social worker to offer the challenged testimony is a reversible error in a case predicated entirely on medical complexity.
Social Worker’s Testimony
{¶ 50} The relevant testimony of the social worker presented at the adjudicatory hearing, including the challenged testimony, follows.
{¶ 51} The social worker testified that she worked in the NICU at Akron’s and her job responsibilities consisted of “coordinating safe discharge plan with Children Services, making those reports, . . . communicat[ing] with Children Services [and] our medical teams . . . providing support and resources to families with long-term NICU admissions, letting them know about eligible resources . . . [for] their kids . . . based on their chronic conditions . . .”
{¶ 52} She saw D.W., who was “still in the NICU . . . very frequently.” D.W. “has esophageal atresia . . . [which means] [h]is esophagus is not connected, so he’s not able to take anything by mouth. He has . . . a G-tube right now. And he will not be able to even start to take anything by mouth to see if he can do it until that’s repaired.” D.W. was scheduled for surgery on November 17, 2025, but had to undergo a “gap study” which will show if the gap between his intestines is small enough for them to repair. So if it is small enough for them to repair, they plan to take him immediately to surgery following the gap study to repair his esophagus.” Then, “things won’t be okay for a long time.”
{¶ 53} Mother’s attorney “object[ed] to this line of questioning. . . [because it was not] relevant to the events between August 6 and August 29th.” The agency’s attorney responded, “I guess we have covered up to August 29th, but I think a prognosis and diagnosis is relevant when it’s going to be the same whether it’s up to August 29th . . .” The trial court ruled that “it certainly helps with context for the [c]ourt, but certainly the [c]ourt is aware of the time frame depicted in the [c]omplaint. The court will hold the [a]gency to that time frame in making any findings, but I’m going to allow the witness to describe the current prognosis. . . I’m going to overrule the objection.”
{¶ 54} The social worker testified about J.W., saying
[t]here [were] concerns of the canceling of appointments. [J.W.] was discharged and had a follow-up appointment for his skin condition, Ichthyosis. That was canceled and not rescheduled, which was a significant concern on our end as well as a Burn Center follow-up. We were trying to get the Burn Center follow-up to be in, in the NICU, because [J.W.] was going to be admitted on the day [of] . . . the Burn Center follow-up . . . So we were working to contact the Burn Center and ask them to come do the follow-up appointment in the NICU . . . since [J.W.] was up in in-patient.
And the Burn Center had said parents need to be present for that . . . [but] at that time parents were not willing to be present. . . Mom said that the appointment was too early in the morning and that if she needed to be present for it that the appointment needed to be canceled. And in the time frame that [the social worker] went back to [her] office to see if [they]
could move the appointment to any other time in the day . . . mom had walked over to the Burn Center and canceled the appointment herself in person.
{¶ 55} The social worker further testified there were concerns about discharging J.W. to parents following J.W.’s treatment in the Burn Unit, because
parents weren’t present overnight in the Burn Center for the admission.
They reported that they believed [J.W.] had ADHD. And . . . our medical team in the NICU did not agree that the Burn Center did not contact the Child Advocacy Center to have them review the parents’ story with the burns. They did not think that the burns were consistent with the story. So our NICU team . . . wanted to contact the Child Advocacy Center, Doctor McPherson, to get his expertise before discharge . . . [which] was done.
The social worker was asked “if there were inaccuracies or inconsistencies, what would be the standard procedure?” She responded, “[t]o notify Children Services of those.” She did notify an agency worker.
Law
{¶ 56} Evid.R. 702, which concerns testimony by experts, states:
A witness may testify as an expert if the proponent demonstrates to the court that it is more likely than not that all of the following apply:
(A) The witness’ testimony either relates to matters beyond the knowledge or experience possessed by lay persons or dispels a misconception common among lay persons;
(B) The witness is qualified as an expert by specialized knowledge, skill, experience, training, or education regarding the subject matter of the testimony;
(C) The witness’ testimony is based on reliable scientific, technical, or other specialized information and the expert's opinion reflects a reliable application of the principles and methods to the facts of the case. To the extent that the testimony reports the result of a procedure, test, or experiment, the testimony is reliable only if all of the following apply:
(1) The theory upon which the procedure, test, or experiment is based is objectively verifiable or is validly derived from widely accepted knowledge, facts, or principles;
(2) The design of the procedure, test, or experiment reliably implements the theory;
(3) The particular procedure, test, or experiment was conducted in a way that will yield an accurate result. witnesses.
Standard of Review
{¶ 57} Father takes issue with the social worker testifying to a medical prognosis because she was not qualified as a medical expert under Evid.R. 702. Since father did not lodge an objection to the challenged testimony with the trial court, we apply a plain error standard of review. State v. Tibbetts, 92 Ohio St.3d 146, 160-161 (2001).
{¶ 58} “[I]n appeals of civil cases, the plain error doctrine is not favored and may be applied only in the extremely rare case involving exceptional circumstances where error seriously affects the basic fairness, integrity, or public reputation of the judicial process itself.” Uretsky v. Uretsky, 2003-Ohio-1455, ¶ 7 (10th Dist.), citing Goldfuss v. Davidson, 79 Ohio St.3d 116 (1997), syllabus. “Indeed, the plain error doctrine implicates errors in the judicial process where the error is clearly apparent on the face of the record and is prejudicial to the appellant.” Skydive Columbus Ohio, LLC v. Litter, 2010-Ohio-3325, ¶ 13 (10th Dist.), citing Reichert v. Ingersoll, 18 Ohio St.3d 220, 223 (1985). For an appellate court to reverse a judgment under a plain-error analysis, the appellant must show “an error occurred, that the error was obvious, and that there is ‘a reasonable probability that the error resulted in prejudice,’ meaning that the error affected the outcome of the trial.” State v. Bailey, 2022-Ohio-4407, ¶ 8, quoting State v. McAlpin, 2022-Ohio-1567, ¶ 66, quoting State v. Rogers, 2015-Ohio-2459, ¶ 22. So, the appellant must demonstrate that “but for a plain or obvious error, the outcome of the proceeding would have been otherwise, and reversal must be necessary to correct a manifest miscarriage of justice.” State v. Quarterman, 2014-Ohio-4034, ¶ 16.
Analysis
{¶ 59} Upon review of the record, we observe that it is not disputed that the social worker was not testifying as an expert witness. Our examination of the record and father’s arguments shows that he does not mention how the inclusion of the challenged testimony, even if error, would have affected the outcome of the hearing.
{¶ 60} Considering the challenged testimony within the context of the adjudicatory hearing and the applicable law, we find that father has not demonstrated that but for the challenged testimony (about the long-term surgical prognosis of D.M.’s issues with his esophagus and the life-threatening nature of J.M.’s skin condition), the outcome of the adjudicatory hearing would have been different, such that there would have been a finding by the trial court that the twins were not dependent. Consequently, we conclude that father has failed to establish that the admission of the challenged testimony amounted to plain error. Accordingly, father’s third assignment of error is not well-taken.
Fourth Assignment of Error
{¶ 61} Father argues the trial court abused its discretion by ordering a psychological evaluation without a nexus. He contends that “[w]hile a trial court has broad discretion in adopting case plans, that discretion is not absolute. A requirement must affect a ‘substantial right’ to be appealable. In re N.F., 2018-Ohio-4907 (6th Dist.).”
{¶ 62} Father submits “the court ordered a full psychological evaluation because, ‘I think there is some concern about competency . . . there may be some additional services that might be necessary to put you in a position to be competent parents moving forward. And I think the psychological evaluation will be instructive to that particular issue.’” He asserts, however, that there was no evidence of psychological impairment at the time of the twins’ removal.
{¶ 63} The agency counters the dispositional hearing shows that father did not pick up J.M. and “very limited reacted with [J.M.],” and at the adjudicatory hearing, the caseworker testified she was not able to communicate with father because he growled at her so she “was unable to formally talk to him about the concerns that the [a]gency had at that point.” The agency further observes that at the dispositional hearing, the caseworker testified that “I know with father, the reason for [the] risk contributor was he would not communicate with [her]. And [she didn’t] know if that’s out of just not wanting to communicate, if that’s a cognitive delay.”
Law
{¶ 64} In the case of In re N.F., cited by father, one of the issues raised was whether or not an appellate court has jurisdiction over a trial court’s interlocutory order. More specifically, it was argued by the agency that the arguments raised by the appellant were not subject to appellate review because the trial court’s journalization of the case plan was not a final and appealable order. Id. at ¶ 17. The agency also argued that the terms of the case plan were subject to change at any time and were therefore not in the purview of the appellate court’s jurisdiction. Id. This court found that “the arguments raised in appellant’s assignments of error concern the juvenile court’ s adoption of certain case plan requirements, which may be modified at any time prior to a final judgment under R.C. 2151.412(F)(2)(a). These case plan requirements had no impact on the trial court’s dependency finding or its award of temporary custody . . . Thus, we find that we lack jurisdiction to review the juvenile court’s journalization of the challenged case plan requirements. Id. at ¶ 20. In support, this court cited, inter alia, In re B.M., 2012-Ohio- 4093 (9th Dist.).
{¶ 65} In In re B.M., one of the assignments of error challenged the aspect of the trial court’s dispositional order which ordered the mother to obtain a psychological evaluation as part of the case plan. Id. at ¶ 20. The appellate court found that issue did not affect the mother’s substantial rights, nor did it determine the action as to that issue, thus the appellate court was without jurisdiction over the interlocutory aspect of the trial court’s order. Id. at ¶ 24.
Analysis
{¶ 66} Upon review of the record and the applicable case law, we find that we are without jurisdiction over the interlocutory portion of the trial court’s order for father to undergo a psychological evaluation as part of the case plan. Accordingly, we will not reach the merits of father’s fourth assignment of error.
Fifth Assignment of Error
{¶ 67} Father argues the finding of reasonable efforts was unsupported by the record. He observes the agency must demonstrate diligent efforts to facilitate reunification between parents and the twins, citing In re Brittany W., 2005-Ohio-3201 (6th Dist.). He claims the record reveals the agency’s primary reunification service, Help Me Grow, was not available, so referring parents to a waitlisted program while criticizing them for a lack of competent parenting does not constitute reasonable efforts. Father also asserts the agency’s placement of the twins two hours from parents’ home created a state- imposed barrier to bonding that gas vouchers alone could not mitigate.
{¶ 68} The agency counters father’s assigned error is misleading in that it is about choices that father did not make even though services had been offered. The agency contends that at the adjudicatory hearing, the caseworker testified that parents were asking general questions about the safety plan because they were potentially unwilling to comply with it, as they did not want the agency involved. The agency submits the social worker testified at the same hearing that the NICU had completely private rooms with a bathroom, shower and a couch which folds into a bed, so families were encouraged to stay there. The agency argues that the social worker also mentioned the Ronald McDonald House, directly across the street from the hospital, which was set up like a hotel, so parents could have easy access to their children when the parents live a distance away.
Law
{¶ 69} R.C. 2151.419(A)(1) provides in pertinent part:
. . . [T]he court shall determine whether the public children services agency . . . that filed the complaint in the case, removed the child from home, has custody of the child . . . has made reasonable efforts to . . . prevent the removal of the child from the child’s home, to eliminate the continued removal of the child from the child’s home, or to make it possible for the child to return safely home. The agency shall have the burden of proving that it has made those reasonable efforts. . . In determining whether reasonable efforts were made, the child’s health and safety shall be paramount.
{¶ 70} “‘In determining whether the agency made reasonable efforts, “the issue is not whether the agency could have done more, but whether it did enough to satisfy the reasonableness standard under the statute.”’” In re T.C., 2023-Ohio-1922, ¶ 33 (6th Dist.), quoting In re I.P., 2015-Ohio-4061, ¶ 37 (6th Dist.), quoting In re D.H., 2013- Ohio-5286, ¶ 21 (6th Dist.). “‘“[R]easonable effort”’ is an “honest, purposeful effort, free of malice and the design to defraud or to seek an unconscionable advantage.”’” In re T.C. at ¶ 33, quoting In re I.P. at ¶ 37, quoting In re D.H. at ¶ 21.
Analysis
{¶ 71} Upon review of this assigned error, father’s only citation to legal authority is to In re Brittany W., 2005-Ohio-3201 (6th Dist.), for the proposition that the agency must demonstrate diligent efforts to facilitate reunification between parents and children. However, this case does not mention diligent efforts or reunification.
{¶ 72} A review of the record shows the case plan set forth numerous resources for father and steps to help him and his family, including: undergoing intake/assessment for mental health concerns; completing a psychological evaluation; completing a parenting program(s), attend all classes with parenting education specific to the twins’ age, development, and unique needs; actively participating in all visits with the twins; and attending all appointments for the twins.
{¶ 73} The trial court, in its November 14, 2025 judgment entry, following the November 13, 2025 adjudicatory hearing, found “that reasonable efforts to prevent removal were not made by the [agency] because the minor children were removed during an emergency in which the children could not safely remain at home.” Thereafter, in its
November 20, 2025 judgment entry, following the dispositional hearing that same day, the trial court found “that the [agency] made all reasonable efforts to prevent the placement and that placement outside the home of . . . (parents) is in the best interest of the children and that the children’s placement is in the most family-like and least- restrictive setting available and in close proximity to the parents’ home, consistent with the best interest and special needs of the children.”
{¶ 74} While father argues that the agency’s primary reunification service, Help Me Grow (for which parents were on a waiting list), does not constitute reasonable efforts, the record shows other services were offered to father by the agency, some of which he did not fully use or use at all. Moreover, nothing in the record reveals that Help Me Grow was the primary reunification service offered by the agency, as suggested by father. The record does show, however, that father was given opportunities to hold the twins and bond with them at visits and medical appointments, but he did not take full advantage of these opportunities; some visits with the twins were cancelled or father left early and father did not attend all of the twins’ medical appointments, procedures and surgeries.
{¶ 75} The agency worker testified that father did not pick up J.M. and had very limited interaction with the baby at a medical appointment, and father was unable to buckle J.M. into his car seat or fasten the carrier into place in the car. Father also had issues handling D.M. despite being educated by hospital staff on numerous occasions on how to do so. Father was offered financial assistance in the form of gas vouchers and hospital services like the NICU’s completely private rooms and the Ronald McDonald
House to encourage more interaction and promote bonding with the twins, but these offers were refused.
{¶ 76} We find, based upon the record and the applicable law, that the agency acted diligently in providing appropriate services to father and the family in attempts to grow the relationships between parents and the twins and to facilitate reunification of the family. We further find that the agency, by offering the case plan services, demonstrated an honest, purposeful effort to reunite the family. We therefore conclude that the trial court’s finding that the agency made reasonable efforts was supported by the record. Accordingly, father’s fifth assignment of error is not well-taken.
First Assignment of Error
{¶ 77} Father argues that the adjudication of dependency was against the manifest weight of the evidence. He observes that pursuant to R.C. 2151.04(C), a dependent child is one “whose condition or environment is such as to warrant the [S]tate . . . in assuming the child’s guardianship.” He contends that this court “has consistently held that while a ‘no-fault’ finding is possible, a parent’s conduct is relevant only insofar as it forms a part of the child’s environment and has a detrimental impact on the child.” He cites, inter alia, In re A.C., 2010-Ohio-4933, ¶ 74 (6th Dist.), where this court set forth:
“‘[A] finding of dependency under R.C. 2151.04 must be grounded on whether the children are receiving proper care and support. The focus is on the condition of the children, not the fault of the parents.’” In re Bibb. . ., 70 Ohio App.2d 117, 120 . . . [(6th Dist. 1980)] . . . However, a court may consider a parent’s conduct insofar as it forms part of the child’s environment. In re Alexander C., . . . 2005-Ohio-6134, ¶ 51 [(6th Dist.)], citing In re Burrell . . ., 58 Ohio St.2d 37, 39 . . . [(1979)]. A parent’s conduct is significant if it has an adverse impact on the child sufficient to warrant [S]tate intervention. In re Ohm, . . . 2005-Ohio-3500, ¶ 21 [(4th Dist.)], citing In re Burrell, 58 Ohio St.2d at 39 . . .
{¶ 78} Father asserts the trial court explicitly based its finding on the twins’
medical fragility rather than a deficient environment. He claims the court stated, “I think maybe some of the things . . . father’s recent surgery . . . and certainly the high needs of the children, all played a role in the conditions of environment that justify [a]gency intervention.” He contends this interpretation effectively adjudicates the twins dependent based on their own diagnoses, and “the ‘detrimental’ medical crisis, J.[M.] turning blue, occurred while the child was under an [a]gency[-]approved safety plan with the grandmother.” He argues that finding parents’ home environment detrimental due to a crisis which occurred with a State-sanctioned caregiver is a manifest miscarriage of justice.
Standards of Review
{¶ 79} Adjudication that a child is dependent must be supported by clear and convincing evidence. R.C. 2151.35(A)(1); Juv.R. 29(E)(4). “Clear and convincing evidence is that measure or degree of proof which will produce in the mind of the trier of facts a firm belief or conviction as to the allegations sought to be established.” Cross v. Ledford, 161 Ohio St. 469, 477 (1954).
{¶ 80} A manifest weight of the evidence challenge looks to whether the State met its burden of persuasion. State v. Reillo, 2026-Ohio-2701, ¶ 24.
Weight of the evidence concerns “the inclination of the greater amount of credible evidence, offered in a trial, to support one side of the issue rather than the other. It indicates clearly to the jury that the party having the burden of proof will be entitled to their verdict, if, on weighing the evidence in their minds, they shall find the greater amount of credible evidence sustains the issue which is to be established before them. Weight is not a question of mathematics, but depends on its effect in inducing belief.”
(Emphasis in original.) Id. at ¶ 25, quoting Eastley v. Volkman, 2012-Ohio-2179, ¶ 12, quoting State v. Thompkins, 78 Ohio St.3d 380, 387 (1997). “Accordingly, under a manifest-weight review, a court ‘weighs the evidence and all reasonable inferences, considers the credibility of witnesses and determines whether in resolving conflicts in the evidence, the jury clearly lost its way and created such a manifest miscarriage of justice that the conviction must be reversed and a new trial ordered.’” Id. at ¶ 26, quoting State v. Brown, 2025-Ohio-2804, ¶ 30. “[A]ppellate courts may ‘vacate a jury’s verdict and order a new trial “only in the exceptional case in which the evidence weighs heavily against the conviction.”’” Id. at ¶ 27, quoting Brown at ¶ 31.
{¶ 81} “[I]n weighing the evidence, the court of appeals must always be mindful of the presumption in favor of the finder of fact.” Id. at ¶ 28, citing Eastley at ¶ 21. “If the evidence is susceptible of more than one construction, the reviewing court is bound to give it that interpretation which is consistent with the verdict and judgment, most favorable to sustaining the verdict and judgment.” Id., citing In re. Z.C., 2023-Ohio-4703, ¶ 14. An appellate court only disregards that presumption “when evidence contradicts a fact-finder’s findings” or “when a witness’ testimony is so inconsistent as to material facts, so impeached, or so fantastical as to make it patently unbelievable.” Id. at ¶ 3. In those instances, the reviewing court sits as a “‘thirteenth juror’ who may disagree with the fact-finder’s resolution of the conflicting evidence.” (Emphasis in original.) Id. at ¶ 27, citing State v. Martin, 2022-Ohio-4175, ¶ 26.
Law
{¶ 82} The child’s present “condition or environment” is the focus when determining, pursuant to R.C. 2151.04(C), if the child is dependent in order to warrant the State, in the child’s interests, to assume the child’s guardianship. In re N.J., 2017- Ohio-7466, ¶ 20 (12th Dist.). “‘[T]he law does not require the court to experiment with the child’s welfare to see if . . . [the child] will suffer great detriment or harm.’” “‘[T]he child does not first have to be put into a particular environment before a court can determine that . . . [the] environment is unhealthy or unsafe.’” Id., quoting In re A.P., 2006-Ohio-2717, ¶ 28 (12th Dist.), quoting In re Burchfield, 51 Ohio App.3d 148, 156 (4th Dist. 1988) and In re Campbell, 13 Ohio App.3d 34, 36, (12th Dist. 1983). Thus, circumstances which give rise to a legitimate risk of harm to a child may suffice to support an adjudication of dependency under R.C. 2151.04(C). In re N.J. at ¶ 20.
Analysis
{¶ 83} Upon review, the trial court based its dependency finding on, inter alia, mother and father being new parents, the twins’ high needs and father’s recent surgery. Evidence was presented at the adjudicatory hearing that the agency became involved with parents and the twins due to concerns which arose shortly after the twins’ birth, while the twins were receiving medical treatment. J.M. had numerous hospital visits while D.M. required an extended hospital stay in the NICU. Parents, specifically father, had minimal contact with the twins and did not engage in all of the many opportunities offered to spend time with and connect with the twins. Father also failed to learn about the twins’ medical conditions and treatment from medical professionals to educate himself in order to ensure that he could provide the twins with appropriate and necessary care. Father’s lack of interaction poses a legitimate risk of harm to the twins because they are infants with serious medical issues who rely solely on others for care, treatment and supervision, as they are unable to help or protect themselves.
{¶ 84} We find that the trial court’s adjudication of the twins as dependent was proven by the agency by clear and convincing evidence, as the twins’ environment was such as to warrant the agency, in the interests of the children, to assume guardianship. Since the trial court determines what weight and credibility to give to witness testimony, the court was in the best position to judge credibility, and we defer to its credibility determinations. Moreover, after weighing the evidence and all reasonable inferences and considering the credibility of the witnesses, we find the greater weight of the evidence supported the trial court’s findings, and we further find that father failed to demonstrate that the trial court lost its way in adjudicating J.M. and D.M. dependent children. As such, we conclude that the trial court’s decision is not against the manifest weight of evidence. Accordingly, father’s first assignment of error is not well-taken.
Conclusion
{¶ 85} The judgment of the Huron County Court of Common Pleas, Juvenile Division, is affirmed. Father to pay the costs of appeal pursuant to App.R. 24.
Judgment affirmed.
A certified copy of this entry shall constitute the mandate pursuant to App.R. 27.
Christine E. Mayle, J.
JUDGE
Myron C. Duhart, J.
JUDGE
Charles E. Sulek, J. CONCUR. JUDGE
This decision is subject to further editing by the Supreme Court of Ohio’s Reporter of Decisions. Parties interested in viewing the final reported version are advised to visit the Ohio Supreme Court’s web site at:
http://www.supremecourt.ohio.gov/ROD/docs/.
In re J.M. (In re J.M.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.