In the Interest of T.R.C. v. the State of Texas

• Court: Texas Court of Appeals, 9th District (Beaumont)
• Decided: July 6, 2026
• Docket: 09-26-00019-CV
• Status: Published

Opinion

In The

Court of Appeals

Ninth District of Texas at Beaumont

________________

NO. 09-26-00019-CV ________________

IN THE INTEREST OF T.R.C.

________________________________________________________________________

On Appeal from the County Court at Law No. 3 Montgomery County, Texas Trial Cause No. 14-10-11718 ________________________________________________________________________

OPINION

Mother appeals the trial court’s order terminating her parental rights to her

minor child, T.R.C. (“Tim”).1 Termination of parental rights should be reserved for

“extreme cases[.]” See In the Int. of H.S., No. 24-0307, 2026 Tex. App. LEXIS 533,

at *2 (June 5, 2026). “[A] parental-termination order must always be a last resort

and never a first impulse.” Id. We echo what was said by now Chief Justice

Blacklock in In the Int. of A.M.:

1 To preserve the parties’ privacy, we use pseudonyms to refer to the child, Mother, foster parents, and family members. See Tex. Fam. Code Ann. § 109.002(d); Tex. R. App. P. 9.8(b)(2). 1 Most of the [appeals] this Court receives in parental-termination cases involve parents whose severe abuse or abandonment of their children, debilitating drug addiction, or violent and criminal behavior provide the clear and convincing evidence required for imposition of the draconian remedy of termination. This case is more difficult than most. It raises close questions of evidentiary sufficiency.

630 S.W.3d 25, 26 (Tex. 2019) (Blacklock, J.; concurring in the denial of the petition

for review). We conclude the evidence is legally insufficient to support the trial

court’s finding that the Department of Family and Protective Services (“the

Department”) made reasonable efforts to return Tim to Mother before trial and that

despite such efforts a continuing danger remains in the home that prevents Tim’s

return to Mother. See Tex. Fam. Code Ann. § 161.001(f)(1). We, therefore, reverse

the trial court’s order terminating Mother’s parental rights as to Tim, and render

judgment that Mother’s rights are not terminated. We also conclude the trial court

abused its discretion in ordering that the Department is Tim’s permanent managing

conservator, because the trial court did not make the finding required by section

153.002(c)(1). See id. § 153.002(c)(1). Therefore, we reverse the trial court’s order

appointing the Department as Tim’s permanent managing conservator.

The Scope of Our Review vs. The Parameters of Our Opinion

Although our legal sufficiency review requires us to conduct a thorough

review of the entire record, our rules of procedure require us to “hand down a written

opinion that is as brief as practicable but that addresses every issue raised and

necessary to final disposition of the appeal.” Tex. R. App. P. 47.1 (emphasis added). 2 The distinction between what is reviewed and what is included in the opinion is

particularly important in an appeal from a parental-termination order. “Appellate

opinions in these important cases should distinguish between facts that support

termination and facts that do not, rather than reciting every piece of evidence relied

upon by the government.” In the Int. of A.M., 630 S.W.3d at 27 (Blacklock, J.,

concurring in the denial of the petition for review). We will attempt to heed Justice

Massengale’s wise “caution against the dangers of kitchen-sink approaches to

opinion writing, particularly in the area of parental-termination appeals.” In the Int.

of A.K.T., No. 01-18-00647-CV, 2018 Tex. App. LEXIS 10018, at *47 (Tex. App.—

Houston [1st Dist.] Dec. 6, 2018, pet. denied) (mem. op.) (Massengale, J.,

concurring); see also In the Int. of K.N., No. 24-0881, 2026 Tex. App. LEXIS 535,

at *30 n.3 (June 5, 2026) (declining to recount evidence that “is not the basis of our

judgment[,]” noting, “A kitchen-sink approach risks misleading lower courts as to

what evidence matters.”).

We will not, therefore, rehearse all the evidence the Department offered at

trial and now argues on appeal as support for the trial court’s statutory-predicate and

best-interest findings. As explained below, we do not reach those issues; instead, we

decide this case by answering a separate question—whether the evidence is legally

sufficient to establish, clearly and convincingly, that despite reasonable efforts by

the Department to return Tim to Mother, a continuing danger remains in the home

3 that prevents his return. See Tex. Fam. Code Ann. § 161.001(f)(1). When deciding

what evidence to include in our opinion, we have attempted to focus on the evidence

that answers that question. Nevertheless, voluminous records were introduced at

trial, and in order to comply with Rule 47.1, we must include sufficient details from

those records to explain our disposition of this appeal. See Tex. R. App. P. 47.1

Factual Background

When Tim was 17 months old, he was diagnosed with Type 1 diabetes, a

serious condition which requires careful monitoring of Tim’s blood-sugar level. Too

low a level can be immediately life-threatening; too high a level risks diabetic

ketoacidosis which can potentially cause coma.

Tim has a brother, “Chris,” who is one year younger than Tim. Mother has

another son, “Trevor” who is several years older than Tim and Chris, and who was

an adult at the time of trial. In 2016, when Tim was four and Chris was almost three,

their parents divorced. The Final Decree of Divorce, signed in early 2017, appointed

Mother as Tim’s and Chris’s sole managing conservator. Father, who was appointed

possessory conservator, was to have periods of visitation, but these would be

supervised by Tim’s grandmother or someone else approved by Mother, because the

court found credible evidence Father engaged in a pattern of abuse and neglect

directed at Mother and the children. Before any such visitation would be allowed,

however, Father—and anyone else who would be supervising Tim during Father’s

4 periods of possession—would have to complete diabetes education training. No such

requirement was placed on Mother who was granted the exclusive right to consent

to the boys’ medical, dental, surgical, psychiatric and psychological treatment. 2

In September 2018, when Tim was six and Chris was five, Father died in a

motorcycle accident. Years later, when the Department filed this action to terminate

Mother’s parental rights in 2024, Tim and Chris were referred to Elizabeth Salmeron,

Ph.D., for comprehensive psychological evaluations. The Department’s caseworker,

Casandra Duran, informed Dr. Salmeron that Tim and Chris had been placed in

separate homes, and that “the brothers do not have healthy boundaries . . . they fight

often.” Dr. Salmeron did not testify, but her reports which were admitted into

evidence indicate that both boys were dealing with multiple issues, including “grief

and loss[.]” Tim expressed to Dr. Salmeron that he wished Father had “[n]ot

crash[ed] on that day” and that his “dad could come back and the dogs and we all be

together again as a family and the whole world not do bad things.”

Based on information obtained from Tim’s paternal uncle, with whom Tim

had been temporarily placed, Dr. Salmeron’s report indicates that Tim exhibited “the

following problematic behaviors to a moderate to clinically significant degree:” feels

sad; feels down on himself; worries a lot; fidgets or unable to sit still; distracts easily;

2 Father maintained the right to consent to non-invasive medical and dental treatment for the boys during Father’s periods of possession, and surgical treatment in the event of emergency. 5 has trouble concentrating; acts as if he were driven by a motor; fights with other

children; does not listen to rules; does not understand other people’s feelings; teases

others; refuses to share; takes things that do not belong to him; wants things right

away; seems “hyperactive;” temper tantrums; and avoids talking about his feelings.

Although Tim’s paternal uncle also reported that Tim “seems fearful of things that

are reminders of the situation with his mom[,]” when Dr. Salmeron asked Tim the

“one thing [he] want[ed] most in life[,]” Tim responded, “To be back with my mom.”

Tim also told Dr. Salmeron, “I want to see my mom more often[,]” and when asked

what he wished Mother would do differently, he replied, “I think she’s perfect.” As

for what made Tim sad, he said, “My brother not being with my mom and me not

being with my mom.”

Although Tim was, at the time of his evaluation in January 2025, “currently

functioning within the below average range in cognitive ability[,]” Dr. Salmeron’s

report indicates his prognosis was “Fair[,]” and she recommended a “Specialized”

level of care. Her report states:

[Tim] has the necessary cognitive resources to build a productive problem-solving foundation; results suggest [Tim] has the potential to exercise positive stress tolerance and control choices. [Tim] comprehends the importance of cooperation; [Tim] is a good-natured child who benefits from validation, structure and routine. Uncle says [Tim] “is doing okay.” However, assessment information suggests Tim’s internal interpretation of his surroundings is influenced by stress; the impact of early significant loss and trauma also shapes how Tim is learning to “cope” with life. [Tim] has trouble imagining productive outcomes to events; test data show gaps in age level problem solving 6 skills sets. [Tim’s] private thoughts are marked by stress and tension, taking energy that could otherwise be channeled to build a stable coping structure. Given his age, [Tim] likely uses indirect ways of “signaling” needs for support, such as with anxiety-driven behaviors (“aggressive and dominates brother”; “argues with teacher”); the impact of early trauma may interrupt the healing process and leave [Tim] prone to inconsistent response to intervention over time. Test data suggest potential to internalize instead of express feelings; therefore, [Tim] is prone to denial, repression, minimization and avoidance over responsible assertiveness. The effects of uneven processing can exacerbate social problems as [Tim] may have trouble understanding and remembering what is expected of him in an organized fashion. Therefore, helping [Tim] develop productive communication and coping skills using trust-based discipline practices will be an important part of his treatment plan.

We provide more details about the treatment plan recommended by Dr.

Salmeron in our analysis below. But first, we believe it is necessary to include a

description of events referenced in the medical records introduced during the trial,

because the Department relies on those events in arguing that a continuing danger

remains in the home because Mother is unable to manage Tim’s diabetes, unable to

manage Tim’s behavior, and unfit to care for both Tim and Chris.

Three exhibits containing over 12,700 pages of medical records pertaining to

Tim were introduced during the trial, but only a handful of those records were ever

discussed. The Department separately introduced six exhibits containing 33 pages

excerpted out of the 12,700 pages and used those six exhibits to question Mother

about the number of times she removed Tim from a hospital against medical advice.

Only one other witness mentioned the medical records, citing them, globally, as the

7 basis for her concerns about Mother’s having removed Tim from hospitals against

medical advice. Other witnesses expressed similar concerns without mentioning the

records as the source of their knowledge, but none of the witnesses claimed to have

any medical expertise other than a paramedic. The paramedic, readily conceding that

lab values, metabolic status and treatment were “beyond [his] level of ability to

testify[,]” provided limited testimony about diabetes in general and said that it was

necessary for Tim to be transported to a hospital due to elevated blood-sugar on

October 26, 2024. He never referred to, nor explained, any of the medical records.

No doctor or nurse testified, either at trial or by way of deposition. In short,

nobody provided any medical testimony explaining anything contained in the 12,700

pages of medical records introduced into evidence in the trial court and eventually

forwarded to us as part of the appellate record. With that disclaimer, we provide the

following information from the records, focusing mainly on the events described

therein, touching on the medical information only as necessary to provide context

for those events, and hopefully avoiding speculation on medical issues in the absence

of medical testimony to explain the records.3

3 On appeal, the Department lists seven times Mother removed Tim against medical advice, and our review provides excerpts of the records regarding each, along with excerpts of other medical records containing relevant information. 8 December 5, 2018

When Tim was 6 years old, Mother called 911 and an ambulance transported

Tim to the emergency department at Texas Children’s Hospital (“TCH”) The

Woodlands due to “decreased PO intake [and] varying blood sugars (high and low)”

one day after Tim had undergone tonsillectomy and adenoidectomy surgery.

According to the records, Mother was “being demanding” and “interfering with

patient care” while at TCH The Woodlands. “Per mother, she left AMA [against

medical advice] because it took doctor so long to treat patient and were waiting on

more blood work[.]” A social worker got involved and called Child Protective

Services (“CPS”) because the medical staff was unsure whether Mother would take

the child elsewhere for treatment. “Per mother, they left and went straight to

Memorial Hermann ER. She is aware that CPS was called.” Memorial Hermann later

reported to TCH West Tower (located in the Houston Medical Center) that Mother

did, in fact, take Tim to Memorial Hermann, where blood work was done, Tim

received fluids, and Memorial Hermann discharged him home. According to the

records, Mother continued monitoring Tim’s blood sugar levels at home, and later

that same day she called the endocrinology clinic which recommended that she take

him to the emergency center, at which time she took him to TCH West Tower. The

records reveal that while at TCH West Tower, Mother was “upset and yelling at

healthcare staff at 0210 because PCA did not respond appropriately when she called.

9 Morning BG elevated at 292. Mother again upset and yelling this morning at 0800

because she reports that staff is not checking Tim’s BG levels often enough and is

concerned that he is ketotic.”

June 23, 2019

When Tim was 7 years old, Mother took Tim to the Kingwood Medical Center

Emergency Department and reported that Tim had “passed a large ‘bright red blood

clot’ during a BM today.” According to the records, Mother explained that Tim had

been treated at TCH for abdominal pain, fever and gastrointestinal bleeding but was

discharged two days prior with instructions to go to the emergency room if

symptoms returned. 4 After waiting in the Kingwood emergency department for

almost an hour, Mother left against medical advice. The records indicate the reason

for leaving was: “Wait too long, Refused transfer, wants to drive pt to TCH. wait too

long for transfer with EMS.” The records also indicate, “Doctor aware that mother

does not want to wait for transfer to Texas Children’s Hospital downtown and would

rather leave AMA at this time… Per doctor’s order at this time she would like for

primary nurse to put in a CPS case/phone call.” The records indicate that thirty-four

4 The records from TCH confirm Tim had, in fact, been seen at TCH The Woodlands on June 20, 2019, for fever and bloody diarrhea and that Tim was discharged home on June 21, 2019, despite Mother’s statement that “she does not feel comfortable taking child home with continued diarrhea, fever, and elevated blood sugars.” 10 minutes later, Mother and Tim arrived at TCH The Woodlands’ emergency

department where Tim was treated and later discharged.

June 8, 2020

When Tim was 8 years old, someone identified as “step dad” dropped Tim off

at TCH The Woodlands’s emergency department because Tim “was more tired than

normal.” According to the records, “BS on arrival was 533, with Ketones 7.2.” Tim

was diagnosed with diabetic ketoacidosis (DKA) and was admitted to the pediatric

intensive care unit. Mother called and told the social worker that the night before,

she took Tim to Taco Bell, watched him administer an insulin bolus, and then

dropped him off at his paternal grandparents’ house so that Mother and her “entire

family” could pack their things and move to another apartment since their current

one had repeatedly been broken into. According to the records, “Mother stated she

‘hasn’t been able to stop crying’ since she found out patient was admitted[]” but she

would not be able to come to the hospital until the next morning, stating that her ID

was expired and that of her “husband” had been given to the police during their

investigation of the break-in, and had not been returned. The records further indicate,

[Social Worker] was involved due to initiate discharge planning along with CDE and clinical nutritionist as recommended. Mom was not at bedside to initiate discharge planning and education. Mom had reported to night shift that she would be here 06/09/2020 between 0600-0800 to bring home supplies. After numerous unsuccessful attempts to reach mom, [Social Worker] called for a wellness check. When PD arrived at house, mom stated she was sending a gentleman over to pick up the patient. PD initiated a CPS case at this time. The gentleman arrived with 11 no ID and was not allowed to pick up patient. As caregiver needed to be at bedside to receive discharge instruction, education and reinforcement regarding Type 1 DM management. Both mother and CPS arrived shortly after. Mother was visibly upset and frustrated. At this time, we tried consoling mother and letting her know that there still needs to be education to be provided and that with the sensitivity regarding the CPS case, [Tim] was not medically cleared for discharge. Mother continued to be uncooperative and at this time left against medical advice. CPS and [Social Worker] continues to be involved and will be following.

….

CPS recommended not to release patient to mother initially, then agreed to let them go AMA[.]

July 9, 2021

When Tim was 9 years old, Mother took Tim to the emergency center at TCH

West Tower and stated that they had been “around town most of the day, and when

they checked [Tim’s] glucose this evening for dinner it was 551.” She expressed

concerns that Tim’s “Omnipod was malfunctioning” so she gave him an injection

and some water, but he couldn’t drink much due to nausea and when she checked

again it was “still elevated in the 400s,” so she gave him another injection. The

records indicate that Tim’s nausea had “resolved” and his labs were “reassuring” as

he did not meet the criteria for DKA, but “aggressive subcutaneous management”

was recommended. The records indicate,

After discussion with endocrine, recommendations made to mother including POC glucose, correction factor dosing, monitoring for additional 2 hrs. Mother became upset, threatened staff, stated that “we did not know about diabetes”, and that she needed to leave now. Mother 12 had already fed patient Whataburger, gave 2.5 units insulin. We attempted to help to facilitate more rapid additional treatment, reiterated recommendations, however mother refused additional interventions. [Patient] had already pulled out his IV. Mother refused to sign AMA paperwork however this remains AMA. Endocrine on call notified.

Mother at nurses (sic) station and raised voice at nurses, EC MD brought to nurse’s station for update. Mother continued to escalate as she was escorted to room by two EC MD’s. Security called to bedside. After discussion with endocrine and EC medical staff, mother refused to stay for 2 hour observation per endocrine recommendations and mother reports patient removed the IV himself. Mother refused to sign AMA paperwork and left EC with security due to behavior. [Social Worker] notified.

June 15, 2023

When Tim was 11 years old, Tim was transported by ambulance at the

emergency center at TCH West Tower, arriving around 8:00 p.m. According to the

records, Tim had threatened to harm his brother, and Mother was “concerned for

suicidal ideation.” “No acute medical issues [were] identified.” Mental health

services evaluated Tim, and inpatient psychiatric placement was recommended.

Around 10:00 p.m., Tim was examined by Mary Hofstetter, MD, and was medically

cleared. According to the nurse’s notes, around 11:00 p.m., Tim “escalat[ed] after

sitter change… [Tim] called the sitter a ‘pedophille’ (sic) because sitter said she

would need to accompany him to the bathroom for his safety. [Tim] was in the

sitter’s face saying he had corona virus; sitter continued to ask [Tim] to sit back.

13 [Tim] said he would hit her as well.” Around that time, Mother “returned to bedside

after getting coffee[,]” and a different sitter was assigned. By 3:08 p.m. the next day,

Tim was still “[p]ending inpatient psychiatric placement[.] Medically cleared[,]” but

one facility had “deferred admission” and another was listed only as a “potential”

placement and was “still determining if able to perform insulin[.]” Around 6:00 p.m.,

twenty-two hours after admission, and with no placement confirmed, Mother

“verbalized desire to leave with the patient.” Ashley Czaplicki, DO, was notified,

and her 6:23 p.m. entry states:

Called to bedside by nurse. Mother expressed frustration that placement is taking too long and she wishes to leave the hospital. She is frustrated with pt staying in same room for so long and is worried about insulin regimen. I explained that we are following endocrinology recommendations closely. Explained that placement is more difficult given underlying type I diabetes. Mother states that she does not want to wait any longer and would like to take him home. I explained that MHS and our team recommend inpatient treatment and are concerned that he could harm himself/others, disability, have worsening of his condition, and death. Mother expressed understanding and states that “has done this multiple times before. I don’t care if you call CPS. I’ve had CPS visit 10 times before.” Mother expressed understanding that she was leaving against medical advice. Advised return to ER for any worsening of condition such as increased aggression, voicing thoughts of harming self/others, fever, high blood glucose, or unable to eat/drink. Explained that she can return to ER at any time. Mother expressed understanding and agreement.

July 8, 2024

This Court takes judicial notice that on July 8, 2024, Hurricane Beryl struck

Montgomery County. Although it is unclear how Mother, Tim and Chris were

14 affected, medical records from November 2024 indicate, “Mother stated she filed

for FEMA money from Hurricane Beryl in July 2024 and they have been staying at

an extended stay hotel.”

July 25, 2024

Tim woke up vomiting, and his blood glucose was 266, so Mother “called

EMS for concerns for borderline DKA[,]” and Tim was transported to TCH The

Woodlands. Tim, who was 12 years old at the time, was admitted to the PICU, and

was seen by Bonnie McCann-Crosby, MD, for a Diabetes Consult on June 26, 2024.

Her narrative states,

[Tim] reports that he has been feeling bad for the past few days but he didn’t want to tell his mom because he doesn’t like going to the doctor… He is on Omnipod 5 insulin pump and the pump expired yesterday. He reports that he has been missing doses and sneaking food. He does not enter carb amounts in his pump. Mom feels that the Omnipod has not been working as well as his previous Tandem pump. She reports that the pump does not always connect with his Dexcom properly and he is often kicked out of auto mode and either in manual mode or limited mode. He is rotating his pump only on his arms. Doses immediately before eating if he pre-boluses. Reports that blood glucoses in general are in the 200s.

Impression: Established DKA (DKA Resolved w/o ketones) [Tim] is a 12 y.o. [] male with type 1 diabetes, with poor glycemic control. He presented in critical condition with a clinical picture consistent of moderate diabetic ketoacidosis… and moderate dehydration.

15 ….

Diabetes ketoacidosis is a hyperglycemic crises (sic) consistent with lack of insulin. It can result in several complications, including: hyperosmolality, dehydration, hypokalemia, hypophosphatemia, hypoglycemia, VTE, cerebral edema, coma and death. His presentation is suspected to be related to inadequate supervision, missed doses. Management recommendation is outlined below.

We have discussed with the family that [Tim] was in serious condition, and diabetes acidosis carries significant risk of electrolyte abnormalities, cerebral edema and death. Ongoing parental supervision is critical to achieving good glycemic control in children and adolescents and preventing life-threatening complications of diabetes.

Underlying cause for admission related to diabetes is thought to be due to missed insulin doses/inadequate supervision. Areas identified for improvement includes: supervising all doses, taking insulin for all carb meals and snacks, site rotation.

[Tim] and his family will receive assessment by our multidisciplinary diabetes team during the admission to identify barriers of diabetes care, and ensure safe discharge and home care.

Will switch to Lyumjev insulin upon discharge.

Family does not want to continue OP5 upon discharge. They are to follow-up with primary endo about switching back to Tandem pump.

Before being discharged by the hospital, Tim was also seen by Staci Grant,

PsyD, for a Psychology Diagnostic Interview on June 26, 2024. Her narrative states,

Mother provided information surrounding recent admission. [Tim] was reportedly admitted yesterday afternoon after he woke up and reported feeling weak. Mother called EMS for higher level of care and, due to 16 high blood glucose levels, he was taken to TCH ER. Mother reported that she believes this instance of DKA was due to possible “pod malfunction,” as she and [Tim] have had difficulty managing his glucometer and pump for the past few months. She noted that she believes he is experiencing diabetes burnout, given he has been more “forgetful” and “lazy,” and has been sneaking food at nighttime while playing video games. She shared that he was initially diagnosed at 17 months of age and has been admitted for DKA approximately 2 to 3 times. She recognizes that he appears more distressed currently and feels as if he needs to “push through.” As provider spoke with mother, [Tim] briefly mentioned he is “not burned out” and “does not want to do therapy.” Feels “interrogated” in meeting with several providers

Previous Evaluation/Intervention: According to [Tim’s] caregiver, he has previously participated in evaluation and/or intervention including family therapy, individual therapy, and trauma services. Per mother, [Tim] has received multiple services throughout his lifetime and had difficulty recalling dates and names of providers. She noted that he was recently in foster care in 2022 and, as a result of physical abuse, he received trauma-informed care. Additionally, he participated in occupational therapy in 2023. Per mother’s report, she does not believe he has had a good experience with individual therapy, as he continually states that he “does not want to talk” and “feels forced” to participate. He has not received services to address diabetes management and care; however, mother believes a mentor and/or support groups would be more helpful. No official diagnoses

Despite being evaluated on multiple occasions in the past, he has not received any official diagnoses and has been told to address prior trauma.

Current Diagnosis: F43.20 Adjustment Disorder, Unspecified F90.2 Attention Deficit Hyperactivity Disorder, Combined (By history)

17 Recommendations/Plan: 1. Psychology follow-up is warranted and suggested at this time; however, patient refused. Mother was informed about possible reasons to request additional Psychology services should [Tim] be open to support in the near future. She is welcome to ask their provider or call Psychology directly… should they like another appointment.

2. Briefly discussed relationship between health and mood, highlighting impact of trauma and stressors on ability to participate effectively in management of health.

3. Encouraged mother to increase supervision of diabetes care daily and to schedule times for [Tim] to participate in gaming following participation in glucose checks and insulin administration.

Referred to Psychiatry? no

September 8, 2024

Tim woke up with a blood glucose level over 500. Tim was transported by

EMS to the emergency department at TCH The Woodlands where Tim informed the

staff that when he woke up, he found that his omnipod had expired. According to the

records, Tim was examined by Nancy Shan, MD, who reported Tim was “not in

DKA.” Nevertheless, Tim was admitted to the hospital with a nurse’s admission note

that indicates, “Patient received from EC with diagnosis of DKA.” He was

“accompanied by older brother [Trevor], [who] claims he is 20 yo and another

sibling, 10 yo. [Trevor] claims he is the guardian, and signed consent and other

documents at EC for admission[.]” The nurse’s notes indicate,

Received an outside call…claims to be mother of patient. Told her Im (sic) am not able to give information since I have not met her and she does not have the code. She wanted to speak to the doctor ASAP 18 because she said did not give consent for her son to be admitted. She said her son is not in diabetes ketoacidosis, and that she can manage this at home. Claims that the patient’s pump just malfunctioned last night. Mother said that she wants her son discharged[.]

Dr. Shan’s narrative indicates,

[M]other not at bedside, older brother signed consent in ED to admit Patient. MD spoke to mother over phone with bedside RN present. Mother angry and belligerent on phone, stating that she did not want her child to be admitted as he is not in DKA and she can take care of his diabetes at home. Agreed with mother that yes, patient is not in DKA however his glucose and ketones were very elevated, and he required IVF and frequent insulin injections to prevent him from progressing into DKA. Updated mother that patient’s labs are improving but he has not yet met Endocrine criteria for discharge. Any premature leaving the hospital would be against medical advice. Mother stated that “Woodlands is stupid, they don’t know what they are doing, they are harming my child” and that she will sue the hospital. She also stated that if patient is not discharged home with older brother and she came to the hospital, it will be a “big deal”. Security aware of mother’s statements[.]

The hospital’s Discharge Summary states,

Mother arrived to bedside and refused to let RN given insulin for dinner carb coverage. [Social Worker] was notified and arrived outside patient room. As charge RN and MD were going to bedside, received notification from bedside RN that mother had removed patient’s PIV herself and left the hospital with him. MD had spoken to mother earlier on the phone and told mother that leaving the hospital before meeting Endocrine criteria for discharge would be against medical advise (sic). Patient arrived to hospital without insulin pump in place, and uncertain if/when new pump will be placed. He was not covered for his dinner carbs and he is in danger of worsening ketosis and hyperglycemia. Mother left with patient against medical advice. MD recommends CPS being called and patient brought back to ED for continued medical management. [Social Worker] aware.

19 October 9, 2024

Tim was transported by EMS to TCH The Woodlands for a “Behavioral

Problem[.]” According to the emergency department’s records,

Patient reports he gets angry sometimes. Reports he got mad at his brother today and “said some things he didn’t mean”, and got into a fight. Patient admits that he takes care of his diabetes, and monitors his blood sugar with the help of his mother. Mom reports family recently homeless, after moving out of a “questionable” hotel. Mom reports she was recently awarded her financial benefits from death of family member. Today family was at a motorcycle shop looking at dirt bikes, and having a mechanic look at younger siblings dirt bike for repair. Mom reports patient got upset, and started a fight with brother. In the midst of fighting patient was heard saying “I want to kill everyone, and then kill myself”. Patient has history of anger, and aggression. Mom reports she believes he would do it, do (sic) to his past history. Mom reports patient has had outside counseling, and psychiatry, however, due to their current financial situation, he has not been going. Patient unwilling to go into detail about what happened today, or how he feels, but denies current SI/HI, auditory or visual hallucinations. In no acute distress.

Tim was admitted to the hospital and on October 10, 2024, a Diabetes Consult

was conducted by Dr. McCann-Crosby, whose narrative indicates,

He was noted to have hyperglycemia with ketosis in the EC.

He is on an Omnipod pump but does not have a Dexcom currently and has been in manual mode. Per mom he has not been checking his blood sugars. He manages a lot of his diabetes on his own but does get some help from his mother.

Mom reports that they are currently homeless. They were living in an extended stay, however mom was concerned about sex trafficking around the extended stay so they left and have been living in their car. Mom reports that she has 2 pit bulls and it has been difficult for her to find a place to rent that will accept the pit bulls… When asked about 20 the insulin storage, mom reports that it has not been kept consistently in a refrigerator recently…Yesterday [Tim] became upset and threatened to kill mom and his brother and then kill himself. Mom called EMS and they brought him to TCH The Woodlands.

Mom was very upset this morning because she was initially told by the front desk on the 5th floor that they didn’t have record of [Tim] in the system. She reports that [Tim] has been listed under different names during several previous hospitalizations at TCH and she has had difficulty being able to see him during his admissions because “they can’t find him in the system”. She does not want to be admitted to TCH Woodlands in the future because of these concerns. Mom mentioned multiple times that she wants to take [Tim] and leave AMA. She reports that if CPS is called again she will not answer her phone if they call her.

His presentation is to (sic) suspected to be related to missed insulin doses/inadequate supervision, likely bad insulin due to lack of refrigeration [].

We have discussed with the family that Tim was in serious condition, and ketosis could result in acidosis/DKA and significant risk of electrolyte abnormalities, cerebral edema, and death. Ongoing parental supervision is critical to achieving good glycemic control in children and adolescents and preventing life-threatening complications of diabetes.

Of note, the family is currently homeless and patient is not in school currently. [Social Worker] has met with the family and a new CPS case has been opened today. It is recommended that he be admitted to inpatient psych. He is medically cleared from an endocrine standpoint.

Erlene Norris, LMSW, conducted a Social Work Psychological Assessment,

which indicates,

Per mother, she brought pt after he became agitated and got into a physical fight with his younger brother. According to mother, pt 21 became really upset and threatened to Kill himself and his mother and brother.

Pt was previously diagnosed with ODD, ADHD and adjustment disorder. Per mother pt is not receiving treatment or taking any medication. Mother revealed the family is going through a crisis and are currently homeless.

Mother also disclosed they have not been able to go to their endocrine appointments due to their crisis. Sw asked mother to tell her more about her crisis. Mother explained they were leaving (sic) at an apartment and had to leave that apartment and they left the medicines and everything behind. Mother disclosed they have been staying at ‘sketchy” hotels.

[Social Worker] discussed with mother next steps including recommendation for inpatient treatment. Mother reporting she was in agreement as long as she could be at bedside. Mother identified Kingwood Pines as facility of choice.

Four hours later, when an ambulance arrived to transport Tim to Kingwood

Pines, Mother refused to sign the authorization. The nurse’s notes indicate Mother

“[s]tated she will not allow for patient to be transferred to any hospital associated

with TCH. Mother voiced frustration with our hospital contacting CPS. House

Supervisor, Charge nurse, security at bedside to attempt to de-escalate situation to

no avail. Mother walked patient out of unit. Mother refused to sign AMA

paperwork.”

Months later, during Mother’s Psychological Evaluation with Jenny Stadler,

Ph.D., in January 2025, Mother recalled:

22 I was homeless; I was asking for help and I wasn’t getting any help; my children were acting out… My kids don’t deserve this; there is no medical neglect; I had reasons to leave the hospital; [Tim] was having outbursts; he was trying to hurt me or his brother; I called 9-1-1 and took him to the hospital; I want to say he went by EMS; I wanted treatment for him; evaluate, psychologically; he’s had the same thing at this hospital before; I wasn’t able to be there; I met a friend to take [Chris]; [Trevor] was able to get to the hospital at first; they’re saying I can’t go back through the doors; they’re saying he’s not in the system; I get there, and he’s under ‘Thomas’; the security guard had to call another person; I ended up walking back there; I’m there thirty minutes; my child is back there by himself; I’m not a threat to anyone; y’all aren’t doing what you needed to do to check him in properly… What made me upset; it wasn’t that I was against CPS; when they told me what they were saying; I didn’t want that facility to treat my child; they were saying I probably didn’t have insulin for my son…I have left the hospital previously for an incident; I am my son’s advocate if things aren’t done properly; I wasn’t yelling, screaming, cussing.

October 14, 2024

The medical records reveal an endocrinology appointment at TCH was made

on October 14, 2024, and when the appointment was missed, a social worker notified

CPS worker, Aaron Stocks.

Trial Testimony

The foregoing medical history brings us to the events that led to the

Departments’ filing an action to terminate Mother’s parental rights, and the progress,

or lack thereof, toward reunification of the family prior to trial. For a description of

those events, we rely on the trial testimony and records.

23 Aaron Stocks

Stocks testified that he has been an investigator with the Department for four

years. In early October 2024, Stocks received an intake regarding Mother. He

explained that the Department received an allegation that Mother, Tim, Chris and

two pit bulls were living out of a truck and that Tim, who is diabetic and having a

mental health breakdown, was admitted to the hospital with glucose “numbers off of

the charts[.]” According to Stocks, Mother had a history of disregarding medical

advice and was potentially going against a doctor’s recommendation to place Tim in

an inpatient treatment center and wanting to discharge him.

Stocks went to the hospital to interview Mother and Tim. Stocks arrived at the

hospital and observed Mother leaving the hospital. The nurse confirmed that Mother

left, and she did not know when she would come back. Stocks waited 45 minutes for

her to return to the hospital. Upon Mother’s return, Mother did not want to talk to

him and attempted to leave as soon as she noticed him. Stocks calmed Mother, and

they spoke for an hour. Mother told Stocks that the family was living out of her truck

and occasionally in hotel rooms and with friends. She said that she had a cooler for

insulin storage, and that she “periodically” missed some of Tim’s appointments

because of problems with her vehicle. She discussed Tim’s mental health, telling

Stocks that Tim “had a breakdown.” Stocks testified, “I believe he had pulled a knife

on his brother[,] and she felt that it was necessary for him to go to the hospital.”

24 Tim was not transferred to inpatient treatment, and after several attempts to

follow up with Mother and meet Chris, Mother stopped answering Stocks’s phone

calls. Stocks testified that he did receive a call from Mother in which he “answered

the phone and I heard screaming and dogs barking and calling for help from [Mother]

from afar. So[,] it sounded like it was like a pocket phone call.” After Mother stopped

responding, and because Stocks had not had an opportunity to observe Chris, he

issued a “CSCAL. It’s -- I always explain it as like an Amber Alert for children in

the state of Texas. So anytime that we have unseen children, there’s an alert that

goes in with law enforcement in case there’s any contact with the parents. It alerts

that [the Department] is in need to see the children.”

Stocks classified Mother’s case as “reason to believe” because of “[m]edical

neglect, neglectful supervision, and . . . refusal [of] parental responsibility.”

According to Stocks, Mother medically neglected Tim because she “withdrew her

child from the hospital against medical advice[,] [and] missed the next medical

appointment[,]” and committed neglectful supervision because she tested positive

for methamphetamines. According to Stocks, someone reported that the reporter had

smoked methamphetamine with Mother between the time Stocks contacted Mother

and the reporter’s contacting the Department. He also testified that Mother refused

to accept parental responsibility by calling the “cops and said to come pick up her

children. She didn’t want them anymore.”

25 Christopher Sheffield

Sheffield is a sergeant with the Montgomery County Sheriff’s Office. On

October 26, 2024, around 1:30 a.m., Sheffield was dispatched to a call involving

Mother and her two children after being told that pepper spray had been sprayed in

a vehicle affecting several people. When he arrived, Sheffield located Mother in a

black pickup truck in a driveway of a home, and her two children standing in the

street near the driveway. Mother told Sheffield that Tim was “physically [and]

verbally abusive to her[,]” that he was cunning and deceptive, and blamed her son

for the family’s being homeless. Mother reported that Tim threatened her with

pepper spray but that he had not actually sprayed the pepper spray. Mother told

Sheffield that the Department had been involved with the family, and at one point,

Mother asked that the Department come and get her children that night. Sheffield

described Mother’s appearance as “common in people that use stimulant-type

narcotics or drugs[,]” and that Mother was “acting very fidgety” and “did not seem

of normal…sound mind to me.” Mother told Sheffield that she wanted someone to

take her kids because she was “at her wits’ end with them,” and Sheffield “was trying

to help her defuse the situation.” Sheffield was unsuccessful in finding anyone to

take the children. He described the boys as “well-fed[,]…very rambunctious, like

normal boys are. But . . . concerned about the situation as well. They understood that

they were homeless and it -- they seemed to be emotionally affected by it.” Sheffield

26 identified an exhibit that demonstrated Mother tested positive for

methamphetamines three days after he responded to the call.

Jefferson Rampy

Rampy is a paramedic with the Montgomery County Hospital District. He was

dispatched to the 911 call on October 26, 2024. Rampy testified he was called to the

scene because of “concerns about the health of one of the children in question and

. . . they called us for evaluation.” According to Rampy, Tim is diabetic and when

his blood sugar was taken that night, his glucose level was 487. Rampy testified that

normal glucose levels are considered 80 through 120. He testified that Tim’s blood

sugar needs to be regulated with insulin and that Mother told him she had insulin,

but the insulin was not refrigerated. According to Rampy the lack of refrigeration

would have “accelerate[d] the deterioration of the insulin[,]” but even if the insulin

“was kept at room temperature, it would have still been effective.” Rampy testified

that Mother told him that “[t]hey had insulin in their possession. We noted that it

was not refrigerated, and she said that it had been unrefrigerated for less than 28

days, which is important because that’s -- that’s the limit for how long insulin can

be unrefrigerated.” Ultimately, Rampy did not “know whether the insulin was going

bad or not. All I know is she told me it had been unrefrigerated for less than 28 days.

So if that’s true and it was kept at room temperature, it would have still been

effective. I don’t know. I did not pursue the veracity or try to tease that out.” Rampy

27 stated Tim’s glucose levels caused “acute concerns” because it “can affect their

mentation in the long -- in much longer terms, it can have significant detrimental

effects later in life if their blood sugar is not kept under control consistently.” Based

on his training, Rampy stated that a child with glucose levels that high should be

transported to the hospital. According to Rampy, Chris did not have any notable

health issues.

Daniela Hernandez

Daniela Hernandez testified that she is an investigator with the Department.

Hernandez stated that on October 26, 2024, while Stocks was investigating the case,

she “received an additional referral for an immediate assist while I was on call - -

over the weekend.” According to Hernandez, the Department received a report that

“[Mother] did not want the children in her care and wanted [the Department] to take

the children.” Hernandez responded to a home located in Magnolia at 4:30 in the

morning. When she arrived, she found Mother asleep in a black truck. It took “about

an hour[,]” to wake Mother after they arrived. The children were not with Mother,

but in an RV on the property belonging to Mother’s adult son. When Mother awoke,

she appeared “not totally coherent or lucid[]” with “super slow[]” speech and

Hernandez did not believe that she understood the questions being asked.

Hernandez testified that she spoke to Mother for “[a] few hours[]” that

morning. Mother denied calling the Department to take her children but stated that

28 she called law enforcement because Tim “was attempting to mace her or somebody

else.” Mother told Hernandez that the police were “lying against her and making

false accusations against her.” Mother denied all drug use. Mother did not want the

Department to take her children. Mother showed Hernandez Tim’s insulin, but

Hernandez testified “it was kind of unclear whether he was actually getting his

insulin or not.” Mother discussed Tim’s mental health and that Mother believed Tim

would “kill someone.” Mother told Hernandez he was seeing a pediatrician and

getting “in some sort of outside program,” but the information she provided was not

clear to Hernandez. Mother agreed to have Tim transported to a medical facility for

evaluation but refused to send him to Texas Children’s because they had “repeatedly

made false accusations against her, and she was filing a grievance against them.”

During their discussions, Hernandez testified that Mother would become “really mad

at me and start yelling at me,” and that “[she] wasn’t really being cooperative.” The

children were removed that day and placed with fictive kin. Hernandez detailed the

Department’s concerns including Tim’s medical and mental health, Mother’s

substance use, and whether the Department would have continued access to the

children to check their safety and well-being if they were allowed to stay in Mother’s

care. Audio was played in which Mother could be heard saying “I want [the

Department] to take these kids. I can’t deal with this anymore.” Hernandez testified

29 that Mother refused the option of a “safety plan” and told Hernandez that she was

not going to “do anything without a court order.”

Medical records from October 26, 2024, indicate Tim’s clinical picture was

“consistent [with] hyperglycemia with ketosis and mild dehydration which resolved

with IV fluids and insulin in EC,” but he was “not in DKA.” Huda Adnan, LMSW,

a social worker familiar with Tim, was consulted. Her assessment was, “At this time,

pt is here for medical clearance prior to discharge with new placement/caregivers.

Pt is not presenting with psychiatric complaint nor does he require a mental health

assessment. Provider confirm[s] that plan is to DC patient per CPS disposition. No

inpatient psychiatric hospitalization is warranted on this visit.”

Casandra Duran

Casandra Duran testified that she is a conservatorship worker with the

Department. Duran did not describe her educational background or her experience

with the Department, and the record does not indicate that she has any “knowledge,

skill, experience, training, or education” that would enable her to express expert

opinions. See Tex. R. Evid. 702. Duran stated that she has been the conservatorship

worker on this case since the children were initially removed from Mother in October

2024. Initially, Chris was placed with his maternal grandmother and Tim was placed

with a cousin, but due to behavioral issues at school, Tim was removed from his

30 cousin’s home and placed with “Hailey,” who had been Father’s fiancée before he

passed away.

Duran noted the family had supervised visitations on Saturdays and that

sometimes the boys would physically fight at the visitation. According to Duran,

Mother would pull out her phone and record before helping to break it up, which

Duran said was not helpful. On cross-examination, Duran conceded this happened

only one time, in June or July 2025, before the boys were placed back with Mother

in July 2025.

Tim and Chris were placed back with Mother from the end of July 2025 to the

middle of August 2025. Duran recalled that she advocated for Mother to have the

monitored return with her children. Prior to the children’s being placed with Mother

for the monitored return, Mother completed services such as counseling and had

negative drug tests. Duran agreed that at the time of trial Mother had completed all

her services under the family service plan, except for individual counseling sessions.

Duran stated that the Department did have “concerns” after placing the children in a

monitored return, noting the siblings’ fighting, the Department’s history with the

family and whether “the support was going to be there.”

On August 11, Duran received notice that there was an “incident” with Tim.

Mother told Duran that while they were driving home the day before, Tim got upset

and started hitting her. When they arrived home, Tim climbed onto the roof of her

31 home, and she called law enforcement to intervene. Tim was then taken to the

hospital and discharged at 6 a.m. the next morning. At 5 p.m. that same day, Duran

received another call from Mother that Tim was destroying property at Mother’s

home and Duran could hear Tim in the background “screaming, yelling, grabbing at

[Mother’s] phone.” Mother hung up the phone, called Duran back, and asked if Tim

could go back with Hailey. Duran heard Tim in the background saying, “I don’t want

to go.” Mother told Duran “I can’t do this. I can’t do this.” Duran asked what was

needed to calm Tim and sent food to Mother’s home for Tim. Tim eventually calmed

down.

The following Wednesday, Mother called Duran at 8 a.m. stating the boys

were being “disrespectful[,]” and did not want to “get up.” According to Duran,

Mother said “she was just basically saying that it was not fair that we just threw these

kids at her. We didn’t give her enough time to prep.”

On August 18, 2025, Mother contacted Duran and told her that Tim had

another episode and that she took him to the hospital for his glucose levels and

eventually admitted him into a “psych facility.” Duran testified Tim was placed back

with Hailey after he was discharged from UT Health inpatient psychiatric care on

August 28, 2025. The Department was “concerned” about Tim’s diabetes and

Mother’s ability to handle both boys. Duran agreed the Department was “at a loss

on how to fix this[,]” so Tim was not returned to Mother’s care, and the Department

32 allowed her unsupervised visits. The first visit was on September 13, 2025, and

according to Duran, Mother did not say anything happened during that visit, but for

reasons that were not explained at trial, Duran and her supervisor decided Mother

would have supervised visitations from that point forward.5 The first supervised

visitation was on September 24, at Mother’s new home. Duran agreed there was

“nothing inappropriate about [Mother’s] new home.” Everything went fine until the

end of the visit when Tim asked to take a phone Mother had given him to Hailey’s

home, and Duran said, “‘No, we already had a discussion about this. We -- you

know, if [Hailey] wants to get you the phone, she’ll get you the phone.’ And it kept

going at it for about like 20, 30 minutes.” According to Duran, Mother told Tim,

“‘Go ahead and take the phone[,]’ [a]nd I told her directly, I said, ‘No. He’s not

allowed to take the phone.’” During the next visit, on October 8, 2025, everything

was going well until Chris told Mother and Duran that Tim slapped him in the face.

Duran testified that Mother then went inside the home to talk to Tim, and although

Duran tried to keep Chris outside, he followed Mother into the home. Tim then

punched Chris in the face, and although Duran was attempting to stop it by putting

her hand in the way, Tim “just, like, flung my arm.” Duran testified that she has

never seen Tim act this way outside of Mother’s presence. Duran conceded Tim has

5 When questioned about why the visits were changed from unsupervised to supervised, Duran agreed it was not because of anything Mother said or did wrong, and Duran was not aware of any abuse or neglect during that time. 33 told her to “shut up” a few times but has not been physical with her. Duran testified

the Department believes it is not safe for the boys to be together and has “concerns”

about Tim’s medical needs if he were to be returned to Mother. She testified this

belief was based on “[t]he medical records that we have. All the Against Medical

Advice, leaving Against Medical Advice.” Duran testified that she believes it is in

Tim’s best interest to be with his current caregiver, because Tim has “stability[,]”

his diabetes is properly managed, and he is doing really well at school and in her

home.

Duran listed the steps Mother had been required to take under the family

service plan, including psychological assessment, parenting classes, domestic

violence classes, providing a home, allowing CPS to see the home, and getting a job.

Duran agreed Mother was compliant with all the services and performed them to the

best of her abilities. Duran explained that Tim was not returned to Mother upon

discharge from UT Health inpatient psychiatric care because of “[s]afety matters.

With [Tim] pulling out a knife on [Mother] and him being sent to a psych hospital

for aggressive behavior and him not having these behaviors while he was with his

caregiver, it was in the best interest for [Tim] to be placed back with his previous

caregiver for respite.” Duran testified that Tim does not have these behaviors with

his current caregiver. She conceded, however, that Tim has pushed Hailey on one

occasion.

34 According to Duran, Mother cannot handle Tim’s behavior and is not fit to

care for both children. Duran testified that she does not believe Tim is safe in

Mother’s home and recalled an event while Tim was hospitalized in August between

Chris and Mother. “The day when I went to [Mother’s] home, she stated that [Chris]

had gotten on top of her, was punching her, hitting her, had grabbed the broomstick

and was chasing her outside. She had to get on top of the car to get him to stop. He

was punching the walls. He had grabbed a knife. He was playing with the knives.”

Based on that incident, Duran agreed that “it’s a danger for [Tim] to go home in that

situation.”

Duran explained why Chris was returned to Mother and the Department

nonsuited its case with respect to Chris. According to Duran, the Department does

not object to Chris’s being with Mother and has made visits to Mother’s home and

determined that Chris was not being abused or neglected and that Mother was fit to

care for Chris. “It’s not that we’re comfortable – fully comfortable. It’s the fact that

we don’t have another option for [Chris] at this moment. He’s physically okay with

[Mother] but we did not have -- we did think about removing him as well. [W]e did

not have another option.” Duran testified that although there was an episode with

Chris in August, the Department chose to leave him with Mother because he is

physically safe with her. “[W]e don’t have any family members for [Chris] and then,

eventually, it would be either Child Without Placement which is they usually go to

35 a hotel, CWOP, or until we find placement for him at an RTC, something and his

level of care is intense or he stays with Mom. Physically, he’s okay with Mom.” She

explained that it is not the same with Tim and that his behavior and medical diagnosis

is a concern. “[Tim] escalates to the top where he -- if -- it’s really severe. Like,

[Tim] really does escalate. [Chris] can calm down eventually faster than [Tim], but

[Chris] hasn’t had so many incidents like [Tim].”

On cross-examination, Duran conceded, however, that Chris threw a pen at

her on one occasion, explaining, “I’m trying to calm him down. So, of course, you

know, you’re trying to redirect these kids, and they’re going to attack when

somebody is trying to redirect them.” Duran testified Mother was also trying to

redirect the boys on that occasion.

Duran was also asked several questions on cross-examination specifically

about a “continuing danger.” Her testimony was as follows:

Q. So what is it about my client as of today, snapshot, that would indicate that she is a continuing danger to this child?

A. She is not able to handle the behavior when he gets to the point where he’s being very aggressive.

Q. So who’s the dangerous one? Is it my client, or is it [Tim]?

A. [Tim]. But what is provoking [Tim]?

...

Q. So your testimony today as to continuing danger is primarily due to [Tim] acting out, making these threats against my client, correct? 36 A. Correct.

Q. What would alleviate your concerns to allow [Tim] to be back home with my client if he was to be returned home?

A. To be honest, I can’t say because I feel like I -- it’s a lot of concerns at this point with his diabetic -- his diabetes needs, his behavioral needs. I can’t give you just exactly one reason, like –

Q. Well, so far you’ve named his diabetes and his behavior. What else is there?

A. I mean, it’s just what’s triggering him in the home.

Mother

Mother testified that she has two minor children, Tim and Chris.6 She

divorced their father in 2016, and he died in 2018. Mother now receives social

security benefits of around $5,400 per month for her children and herself. Mother

testified she was not employed in the summer of 2024 because she was a “stay-at-

home mom[,]”but she now works “part-time at Pizza Hut.” Mother confirmed that

she is on probation for aggravated assault.7

Mother testified she used methamphetamines for the first time in 2024. The

Department admitted an exhibit that showed Mother tested positive for

6 Mother also has an adult son, Trevor. 7 During her case-related psychological evaluation, Mother told Jenny Stadler, PhD, that “this guy attacked and started strangling my oldest son; I ended up hitting him with this tire tool; I basically almost killed this guy[.]” 37 methamphetamine in 2020, and a psychological report in which Mother admitted

using methamphetamines around age 19 and 20 yet she continued to deny any drug

use before 2024. Mother stated that she bought a pill from someone in 2024 and did

not know it was methamphetamine. Mother testified that she attended substance

classes during the pendency of this case, and that she learned “I would not buy

anything off the street ever again thinking it’s Adderall or my medication.”

According to Mother, after testing positive for methamphetamine in October 2024,

she was tested several times throughout this case, and she has never tested positive

again.

Mother initially testified that she has removed Tim from the hospital against

medical advice only twice. Mother stated that each time, Tim was listed under a

different name at the hospital, but she could not explain why a different name was

used. Mother agreed that Tim’s diabetes diagnosis is a “life-threating[]” condition

but could not recall how many times she left the hospital against medical advice

when Tim had been hospitalized due to diabetic ketoacidosis. The Department

introduced exhibits containing excerpts from the medical records and used them to

question Mother about removing Tim from hospitals against medical advice in

December 2018, June 2019, June 2020, July 2021, June 2023, September 2024 and

October 2024, but Mother could not recall all of the incidents. According to Mother,

each time she removed Tim from medical care, she subsequently took him to another

38 facility for a second opinion. “[T]here’s been numerous times I have left and I have

followed up with either endocrine or his primary care physician[.]” Mother also

testified, “And he’s always been okay after I left.”

Mother stated that Tim has attended eleven schools. She testified, “I believe

that I did what was best for [Tim] due to his behavioral issues as well as his learning

disability. I had to find the appropriate school for him[.]”

Mother testified regarding an incident in May 2024 in which she flagged down

a passerby to call 911 while they were waiting at a red light. Mother recalled that

Tim ran away into the woods when he found out law enforcement and EMS were

responding to the call. Mother testified that she felt there were times it was necessary

to call 911 and seek help from law enforcement because Tim was a danger to himself

or his family.

After Tim was removed from her care, Mother had visitations with Tim in

which she noticed injuries to Tim. Mother testified she notified the Department, and

she did not receive an explanation from either Tim’s caregiver or the Department.

Pictures of the injuries were admitted at trial. She thought that the Department would

help her and the family with counselling and additional services, but she had to seek

counseling on her own for herself and her children. She admitted, however, that the

Department did provide information for counseling services and that Medicaid is

paying for the counseling.

39 Mother was provided with a service plan, and part of the plan was for Mother

to be drug tested frequently, complete a domestic violence course and become

employed. She testified she makes between $1500 and $1800 per month working at

Pizza Hut, in addition to Social Security survivor benefits. Mother testified that she

had recently moved into a new home with Chris. Photographs of the home were

admitted into evidence. Mother stated that she has completed the services that were

required except for individual counseling, because she was not reimbursed by the

Department for the cost.

Mother agreed that “at the last hearing, the Department recommended the

children be returned home to [her].” She testified that after the court authorized the

children to be returned home in July 2025, they were doing well in her home, but in

August she sought help for Tim, and he was hospitalized for a mental evaluation.

According to Mother, Tim had climbed onto the roof and was threatening to touch

powerlines. Tim was then handcuffed and placed in the back of a police car. Tim

was placed in the hospital, then released. Tim was hospitalized a second time in

August 2025, because he pulled a knife on Mother. Mother testified Tim and Chris

did not want to go to bed, and when she told Chris to get off the computer, Chris

obeyed, but Tim went into the room and got on the computer, so Mother unplugged

it, took the power cord and sat down on the couch. Tim then grabbed a knife, and

40 Mother “told him to put the knife down and he refused[,]” so Mother “took

immediate action by calling 911.”

Mother testified she called the Department for help after the children were

placed back in her care in August, but she denied saying the Department “threw” the

kids back to her; instead, she recalled expressing “concerns about them not receiving

adequate counseling and therapy….And I thought that it was very unfair that I’m

trying to look for resources to help them stabilize their mental health and I had no

resource.” Mother testified that she requested Tim be admitted to inpatient care, for

“[m]edication management.” Mother described the different medications that had

been prescribed for Tim in the past and stated that she was following medical advice.

Mother testified that while Tim was hospitalized, she had to call 911 for Chris

because he hit her in the head with a broom and then grabbed a knife. According to

Mother, Chris “was very angry. He was having a mental breakdown. He hadn’t -- he

-- I remember taking him to the hospital. He was denied -- like, he could not see his

brother. He told me it was my fault that [Tim] got ripped away, that I shouldn’t never

called the police and he started stabbing the bed and just putting holes in the walls.”

When Mother was asked whether she made sure to hide the knives, Mother testified,

“I don’t even have any kitchen knives anymore.”

Mother testified that when Tim was removed in August 2025, she was told it

was a “respite[,]” or “[a] break…just a cooldown time[,]” but Tim was not returned

41 to her care. Mother testified that since Tim was released, the Department has not

provided any help and has not made any efforts to reunite Tim with Mother and

Chris. According to Mother, she understood the family service plan to outline the

actions that were necessary to obtain the return of her children, she did everything

she could to the best of her abilities, she has a safe and stable home, and Chris has

been returned to her care, but the Department did not keep their end of the bargain.

Hailey

Hailey testified that she was in a relationship and engaged to Father when he

died in 2018. Hailey testified that while she and Father were together, the boys would

come over to their house, but she did not have contact with the children after Father

died. She learned that the children were placed with the Department in October 2024,

and Tim was placed with her. Chris was placed with his maternal grandmother. Tim

was with Hailey from January 2025 to July 2025 when he was placed in a monitored

return with Mother. After Tim was released from the hospital in August 2025, he

was again placed in Hailey’s home. Hailey testified she had no reservations about

having Tim in her home and that she would be willing to take permanent

conservatorship or adopt him “[i]f it was necessary[.]” She testified that she has not

had any “significant” behavioral issues with Tim, noting his behavior was “[n]othing

that a 13-year-old boy wouldn’t be doing.” She testified that he has not been

hospitalized while in her care. In regard to injuries noted by Mother, Hailey stated

42 that Tim fell off his bike and got road rash, though she did not know how the other

injuries originated, explaining she had never seen any other injuries. When Hailey

testified on Monday, November 3, 2025, Tim had just completed behavioral classes

the previous Friday and was just then returning to regular classes at school. Hailey

testified that she has no concerns about his grades, and that his recent report card

was good. Hailey stated that she does not believe Tim is difficult to care for or that

he is violent. Hailey described her disciplinary methods in a situation where Tim

was argumentative or a “little physical[,]” because he wanted candy, stating she

would walk out of the situation to allow him to calm down, and later he returned the

candy to her and apologized. Other times she takes away electronic devices or

grounds him. Hailey testified that she would not want Chris in her home at this time

because of “the way the boys get when they’re together, it’s very physical, trying to

‘cause, like, immediate harm to each other[,]” but she is not opposed to supervised

visitations between the siblings. She believed it was in the best interest of the

children for them to be kept apart. Hailey testified that Tim’s behavior “varies on

the day” after visitation with Mother. After the last visit Tim came back “irritated.”

Ingram Lee

Ingram Lee testified that he is the guardian ad litem and CASA advocate in

this case, and he and his partner, Sholly Walker, have been involved with the case

and the children since the beginning. Lee did not describe his educational

43 background or his experience as a guardian ad litem or CASA advocate, and the

record does not indicate that he has any “knowledge, skill, experience, training, or

education” that would enable him to express expert opinions. See Tex. R. Evid. 702.

And although lay witnesses are allowed to express opinions that are “rationally based

on the witness’s perception[,]” Lee did not describe any interactions with Tim nor

any observations of Tim while in Mother’s care; he testified only about observing

Tim, “hear[ing] of his behavior[,]” and seeing his report card and progress reports,

during the time Tim was in Hailey’s care. Nevertheless, without objection, Lee

opined that he has concerns for Mother’s parenting:

I’m specifically concerned about her ability to manage [Tim] and [Tim] with his brother. I’m concerned about [Tim’s] physical health. Specifically, have to do with his – the management of his diabetes, his physical danger, the potential for that being in the -- if he’s returned home. And I base that on the fighting between him and his brother. I look at [Chris’s] violence towards his mother. I’m concerned about his emotional needs based on the fighting between the boys and her parenting ability, her ability to manage the two, and I’m concerned about his educational[,] [including] [t]he prior attendance, prior to coming into [the Department’s] care, the number of schools that [Tim] has attended.

Lee testified that he believes there is continuing danger for Tim in Mother’s

home:

I see the management of his diabetes as being primary. I base that on the prior issues that he’s had with -- with [Mother] has had with the – the management of the diabetes. I also base that on the physical violence between the two. And two – … Between the two brothers and, also, the violence of [Chris] with respect to his mother, that that would not be a safe environment for [Tim] to be returned to. 44 At the beginning of the case, Lee did not believe the children should be

separated, but he changed his mind after they were sent to Mother for the monitored

return. He now recommends the boys not be placed together. Lee testified that he

has no concerns regarding Tim’s placement with Hailey. According to Lee, Tim is

doing well in school, has good behavior, and enjoys being with Hailey. Lee stated

that Mother’s conduct caused Tim to be removed from her care in August, testifying

she “[f]ailed to properly monitor the boys and separate them and remove the fighting

that was taking place.” But he noted that calling law enforcement for help and

hospitalizing Tim “was a good thing to do.” Lee stated that his concern is that the

behavioral issues got to the point of calling 911. Lee believed termination of

Mother’s rights would be in Tim’s best interest.

Sholly Walker

Sholly Walker stated she is the other guardian ad litem and CASA advocate

on this case. Like Lee, Walker did not describe her educational background or

experience. She did not indicate that she has any “knowledge, skill, experience,

training, or education” that would enable her to express expert opinions. See id. She

testified she had visited the children frequently while they were placed with an aunt

three years earlier, and although she agreed that she had “read reports and

conduct[ed] an investigation to try to determine the best interest of the children[,]”

she did not elaborate on the “reports” nor the “investigation.” 45 From the beginning of the case, Walker did not believe the boys should be

placed together. Walker testified, “Previously I’d seen in placement, they did not do

well together. They had -- they had blown up their placement in the past case.”8

Walker testified, “They were fine when they were separate and then when they both

were placed with the aunt, they started -- their behavior just got out of control and

they could not handle them.” Walker opined that termination of Mother’s rights

would be in Tim’s best interest. She based this opinion on “[b]ehavior, parenting. I

just don’t see how she can handle both boys together.” She also had concerns about

Tim’s health and Mother’s removing Tim from hospitals against medical advice.

Walker had no concerns about Hailey or Tim’s placement with her. Walker denied

being aligned with the Department and testified she is “aligned with the kids’ best

interest.” Walker conceded that she had not observed the brothers together since the

beginning of this case, that when she did observe them for this case, they appeared

8 Mother testified the boys were placed in CPS custody in 2021 because Tim “was overdosed by a school district[.]” Records from the Montgomery County Sheriff’s Office show that in March 2022, the foster mother called 911 because Tim was “being violent in home” and had to be “restrained by foster mother[.]” According to the foster mother, Tim “started acting out because he wanted her to help with a puzzle, she said no so he pushed the table and pieces went everywhere and he hit his brother[.]” While she was on the phone with 911, Tim was “actively violent” and was “still fighting with her… kicking and trying to break things… arguing [and] threatening to punch her[.]” The foster mother told 911, “if she would let go of him he would run away… last time he ran off and it took them 45 minutes to catch him… there is no reasoning with this 9yo[.]” 46 to get along and were bonded, and that she never actually observed a physical

altercation between the boys.

Korosh Memar

Korosh Memar testified that he is Mother’s employer and that she has been

working for him since June. Memar stated that Mother is “always on time. She

always showed up. If we need help, she’s always there and she works hard.” Memar

recalled an incident he witnessed this past summer at Mother’s home after the

children were returned to her for a monitored return. Mother’s car was broken, and

Memar was providing transportation to and from work for Mother. That night

Memar observed the following:

So [Mother] had both of -- both of the kids, they were fighting and so on the way home, she sat in the back seat with [Tim] and [Chris] sit[ting] in the front seat. And then they were fighting in the car, too. As soon as we pull up to her house, when they get out the car, they would start fighting and hitting each other[]. And then [Tim] take the - - jumped the roof. Like, he was -- he went on the roof.

He went to the – there was like a little awning by her door. So he jumped on that. He climbed onto the roof.

Memar called law enforcement because he believed it was dangerous for Tim

to be on the roof. An ambulance arrived, and Tim was taken to the hospital. Memar

testified that he has no safety concerns about Mother and the boys.

47 Dianne Sheldon

Dianne Sheldon testified that she was Tim’s special education teacher in third,

fourth, and fifth grade. She described Tim’s behaviors when she was his teacher as

“very aggressive behaviors, attention-seeking behaviors, avoidance behaviors,

depending on situations and what was going on. He was very unpredictable. It took

a lot to get to knowing him and being able to figure out where the behavior was

originating from in order to help him direct alternative behaviors that could get the

results he wanted.” Sheldon described an incident when Tim was getting insulin

from the school nurse:

There was an argument between [Tim] and the nurse over how much insulin he should get and the nurse told him what bolus -- I think it was called bolus -- to put in his little machine and based on the experiences I had had, I was concerned with the amount that was going and I felt [Tim] was correct with what he was wanting. But he did what the nurse had requested[,] and I asked him a lot of questions after that and after - - after that, his behavior became very, very aggressive and defiant.

According to Sheldon, anytime Tim’s “sugars were off[,]” his behavior would

“severely change.” Sheldon testified that when Tim’s sugars were off, he would

become “more aggressive[,]” and his behaviors escalated. “[I]n particular,

oppositional defiance behaviors and aggression would change primarily with low

sugar with, like, if he had gone low.” She also observed Mother with Tim together,

and when asked whether she observed anything that would lead her to believe

Mother would put Tim in danger, Sheldon responded, “Just the opposite.”

48 Tim

Tim was thirteen years old at the time of trial. He testified, “I would love to

go back with my mom. Like, I love her. I want to be back with her.” Tim said that

he missed his brother and that “we might fight and argue a little bit, but that’s how

brothers are going to be.” He said that staying with Hailey is “good. I have fun. You

know, I go out on the dock. I fish.” But given the choice to stay with Hailey or go

back to his Mother, he would want to go back with Mother because “I love my mom.

She’s my mom. She’s never not going to be my mom.” He testified that he has his

diabetes under control and that he believes Mother has a good handle on his diabetes

treatment. He testified that if Mother’s parental rights were terminated it would have

a negative effect on him and that he would be hurt and sad not to be with his family.

He does not want to be adopted, he wishes to go back with Mother.

Trial Exhibits

The Department introduced forty-five recorded 911 and law-enforcement

calls along with transcripts of the 911 calls. The Department also introduced police

reports filed in relation to the 911 and law-enforcement calls. The calls included

reports from individuals accusing Mother of crimes, and of Mother calling and

accusing others of crimes. Relevant to the children are the following calls:

February 15, 2019 – Mother reported that Tim was injured while being restrained at school.

49 July 9, 2019 – Law enforcement investigated Mother for reported child abuse after a report was filed with the Department. The police report indicated that Mother was using methamphetamines in front of her children, taking her children to a drug house, and current boyfriend was “physically aggressive” with her oldest child, but determined oldest child was aggressor. Children made no outcry of abuse.

June 9, 2020 – Law enforcement conducted a welfare check on Mother reported by a social worker at Texas Children’s Hospital. Tim had been dropped off at the hospital for issues with his diabetes. Mother told the hospital she would be come to the hospital in the morning but had not done so, and the hospital was unable to reach her. Mother told law enforcement, “I have someone on their way to get my son and my phone is disconnected and I just need to pay the bill!” Law enforcement subsequently contacted the Department, and although the Department placed “a hold” on [Tim], Mother was able to leave the hospital without discharge papers.

April 7, 2022 – Law enforcement was called upon to investigate allegation that Tim was abused while in foster care.

April 30, 2023 – Mother called law enforcement because of Tim’s behavior, including threats against his brother and to harm himself, and requested that Tim be hospitalized due to his behavior. Tim ran away before law enforcement could arrive on the scene.

June 11, 2023 – Report that Tim and Chris said a man was waving a gun at their home and threatening everyone. Mother had locked herself inside the home. The incident was reported to the Department.

May 10, 2024 – Call received from passing motorist in Montgomery County. Mother had flagged down motorist for assistance because Tim was becoming “belligerent” while driving to a doctor’s appointment for his diabetes. Mother told law enforcement that Tim was attempting to attack her while driving. Tim was placed in handcuffs and put in the backseat of the patrol car and successfully slipped out of his seatbelt several times. Tim was admitted to the hospital on that day.

October 26, 2024 – Mother called 911 stating she was pepper sprayed by [Tim]. Law enforcement determined no one had been pepper 50 sprayed. Mother reported that Tim is “out of control, violent, and commonly attacks her.” Mother told the officer she could not “handle them anymore.” The report described Mother as “agitated and she was fidgeting[] [and] [h]er concentration was scattered and erratic.” Mother stated she is homeless living with her children and her two dogs in her truck. Children reported they have not been to school in several weeks. The officer noted that both children appeared to have behavioral and attention problems but did not appear assaultive or violent. After attempting to find placement for the children, and reporting to the Department, the report stated that officers could not wake Mother up from the locked front seat of the vehicle and multiple attempts were made to wake her. The officer learned that there is a current investigation with the Department, and the Department has attempted to contact mother for several months.

Other exhibits included EMS records, Tim’s school records, drug screen

results for Mother that were positive for methamphetamine and marijuana in 2020,

several negative drug screens in 2021, 2022, and a drug screen on October 29, 2024,

positive for methamphetamine in hair but not in urine. Mother introduced copies of

certificates for completing classes on parenting skills, anger management, domestic

violence, drug and alcohol awareness, and batterer intervention in December 2024

and January 2025, along with photographs of Mother’s home and of the children and

Mother together.

A copy of a psychologist report prepared by Dr. Jenny Stadler on February 7,

2025, about Mother was admitted and states:

[Mother] attended two sessions for this evaluation. During the first session she completed the written assessments and a clinical interview. During the second session she completed various assessments of intellectual and neurocognitive functioning. Her demeanor, thought process, and mood were consistent over the two sessions. 51 ….

[Mother’s] general intellectual functioning was within the Very Low range… However, it should be noted that [Mother] reported a work history that appears to be inconsistent with the level of intellectual functioning that was found in testing. Additionally, this work history would rule out the possibility of a very low level of adaptive functioning. It is possible that a more detailed assessment of intellectual functioning would find more areas of strength. However, there are also concerns that the current assessment may represent a significant decline in functioning for an unknown reason.

… [Mother] was found to be severely impaired when faced with distractions. It should be noted that [Mother] reported that she had taken stimulant medication for ADHD on the morning of the evaluation and consequently her functioning should have been optimal. These results support a diagnosis of Attention-Deficit/Hyperactivity Disorder, combined presentation, and these results also suggest that her current medication is not as effective as would be desired… [Mother] was found to have impairments in various executive functions, including cognitive flexibility and reasoning. These impairments in attention, memory, and executive functioning can significantly impact the ability to benefit from services and also can lead to significant difficulty with effective functioning and organization on a daily basis… [I]t is unknown whether these current impairments have been present over a long period of time, or if they represent notable decline in [Mother’s] functioning.

In regard to ability to parent, [Mother] scored within the range of non- abusive parents on a measure of potential for child abuse, however this result was invalidated clue to a level of defensiveness. [Mother] reported that she experienced physical abuse. She reported that she had used corporal punishment with her children but discontinued this practice as she believed it to be ineffective and counterproductive. Taken together, there is some risk for physical abuse, and this risk 52 increases if she is unable to maintain abstinence and appropriately manage her medication. Regarding the risk for neglectful parenting, this is related to the risk for relapse. In addition, there is risk related to her impairments in attention, memory, and executive functioning which likely lead (sic) to disorganization and impulsive, and possibly poor, decision-making.

The [Department’s] goal for this case is Family Reunification with a concurrent goal of Relative Adoption. This evaluation has indicated risk. [Mother] was found to have a number of impairments that can impact her ability to benefit from services. [Mother] expressed care and concern for her children. Her self-reported work history suggests that at one time she had the cognitive resources to develop the skills needed to create a safe, secure, and stable environment for her children. It is possible that remedial services could help her return to that level of functioning, however this is not certain. The following services are recommended to support [Mother’s] functioning as a parent, and to help her develop more appropriate coping skills. If [Mother] is able to successfully complete these services and demonstrate the ability to provide a safe, secure, and stable environment for the children, the primary goal may be supported.

The report recommended that Mother develop a medical strategy to help with

her ADHD, attend individual and family therapy, substance abuse therapy, and a

medical evaluation to rule out a decline in cognitive functioning.

Psychological Reports pertaining to Tim and Chris were also admitted. Dr.

Salmeron’s report recommended consideration of a number of therapies for Tim,

including individual therapy (to develop self-esteem, effective self-expression and

adaptive coping skills), individual supportive therapy (“to develop associations

between emotions and behavior[,] [t]each how to identify situations that trigger

53 escalation… and to implement productive stress management and problem-solving

strategies”), child anxiety resources, group therapy, family/sibling therapy, “an

evidence-based therapeutic approach shown to improve behavior patterns of

children with symptomatology linked to trauma, depression, poor mood control and

anxiety[,]” “evidence-based techniques” focusing on “process[ing] grief and loss[,]”

and “[c]onsultation with a behavioral specialist to assist in developing a behavior

management program in home and school[.]”

Mother also introduced a copy of the Status Report to the Court filed by the

Department in November 2024. This report indicates, “The permanency goal for

[Tim] and [Chris] is Family Reunification with a concurrent goal of Relative/Fictive

Kin Adoption. The goals are appropriate. The required services will give [Mother]

the opportunity to make the necessary changes to provide a safe and appropriate

environment for [Tim] and [Chris].” To meet Tim’s needs, the report recommended

“Mental Health Counseling” and “Pediatrician follow up regarding depression,

eating disturbance, physical and sleep[.]”

Mother admitted a copy of her family service plan which included

requirements that Mother provide a home that is “safe, stable and appropriate” for

the boys, build a social support system, provide monthly verification of employment,

submit to random drug testing throughout the life of the case, and “work with the

54 caseworker throughout the life of the case to help her understand why the

Department is involved.”

Mother’s exhibits also included two Permanency Report[s] to the Court –

Temporary Managing Conservatorship filed by the Department in March 2025 and

July 2025. Each report indicated the primary goal was family reunification.

According to the reports Tim was receiving individual therapy as of March, and life

skills and family therapy as of July, but each report also noted that Dr. Salmeron had

recommended trauma therapy and group therapy.

At the conclusion of trial, the trial court terminated Mother’s parental rights

and made the Department Tim’s permanent managing conservator. Mother timely

filed this appeal.

Standard of Review

“[P]arental-termination cases stand apart from the rest of civil litigation in

multiple important ways.” D.V. v. Tex. Dep’t of Fam. & Protective Servs., 722

S.W.3d 854, 858 (Tex. 2025). “Actions which break the ties between a parent and

child ‘can never be justified without the most solid and substantial reasons.’

Particularly in an action which permanently sunders those ties, should the

proceedings be strictly scrutinized.” Wiley v. Spratlan, 543 S.W.2d 349, 352 (Tex.

1976) (quoting State v. Deaton, 93 Tex. 243, 248 (1900)).

55 Termination requires proof by clear and convincing evidence. Tex. Fam. Code

Ann. § 161.001(b). “‘Clear and convincing evidence’ means the measure or degree

of proof that will produce in the mind of the trier of fact a firm belief or conviction

as to the truth of the allegations sought to be established.” Id. § 101.007; see In the

Int. of J.L., 163 S.W.3d 79, 84 (Tex. 2005) (citation omitted). This heightened

standard requiring proof by clear and convincing evidence “should not be treated as

a formality.” In the Int. of H.S., 2026 Tex. App. LEXIS 533, at *24. It is “required

because termination affects the fundamental rights of all involved—not just of

parents to their children but also of children to their parents.” Id. at *2-3. Section

161.001 is, after all, “a statute about the judicial destruction of families.” In the Int.

of R.R.A., 687 S.W.3d 269, 284 (Tex. 2024) (Blacklock, J. dissenting). “Termination

of parental rights, the total and irrevocable dissolution of the parent-child

relationship, constitutes the ‘death penalty’ of civil cases.” In re K.M.L., 443 S.W.3d

101, 121 (Tex. 2014) (Lehrmann, J. concurring). Therefore, termination should be

reserved for “extreme cases[.]” See In the Int. of H.S., 2026 Tex. App. LEXIS 533,

at *2. “[N]ot all conduct we find reprehensible justifies this most draconian of

sanctions.” In the Int. of K.N., 2026 Tex. App. LEXIS 535, at *38.

“The clear-and-convincing standard is not just an instruction to be read to a

jury; it instead has meaningful implications on appeal.” In the Int. of H.S., 2026 Tex.

App. LEXIS 533, at *24. We cannot review whether a finding is supported by clear

56 and convincing evidence in the same way that we would review whether a finding

is supported by a preponderance of the evidence. See In re C.H., 89 S.W.3d 17, 25

(Tex. 2002). “Evidence that might be regarded as legally sufficient to sustain a

judgment in a case involving the preponderance standard might constitute no

evidence in a parental-termination case.” In the Int. of H.S., 2026 Tex. App. LEXIS

533, at *25.

“In a legal sufficiency review, a court should look at all the evidence in the

light most favorable to the finding to determine whether a reasonable trier of fact

could have formed a firm belief or conviction that its finding was true.” In re J.F.C.,

96 S.W.3d 256, 266 (Tex. 2002). In a case tried to the bench, the trial court in its

role as factfinder determines the credibility and weight of the witnesses’ testimony

and resolves any inconsistencies or conflicts in the evidence. See Webb v. Crawley,

590 S.W.3d 570, 578 (Tex. App.—Beaumont 2019, no pet.). We defer to the

factfinder’s credibility determinations if they are not unreasonable. See In the Int. of

J.P.B., 180 S.W.3d 570, 573 (Tex. 2005) (citing Sw. Bell Tel. Co. v. Garza, 164

S.W.3d 607, 625 (Tex. 2004)).

To give appropriate deference to the factfinder’s conclusions and the role of a court conducting a legal sufficiency review, looking at the evidence in the light most favorable to the judgment means that a reviewing court must assume that the factfinder resolved disputed facts in favor of its finding if a reasonable factfinder could do so. A corollary to this requirement is that a court should disregard all evidence that a reasonable factfinder could have disbelieved or found to have been incredible. This does not mean that a court must disregard all evidence 57 that does not support the finding. Disregarding undisputed facts that do not support the finding could skew the analysis of whether there is clear and convincing evidence.

If, after conducting its legal sufficiency review of the record evidence, a court determines that no reasonable factfinder could form a firm belief or conviction that the matter that must be proven is true, then that court must conclude that the evidence is legally insufficient. Rendition of judgment in favor of the parent would generally be required if there is legally insufficient evidence.

In re J.F.C., 96 S.W.3d at 266.

Analysis

In her first issue, Mother argues the evidence is legally and factually

insufficient to show that “the Department made reasonable efforts to return the child

to the parent before trial but a continuing danger remains in the home that prevents

the child’s return to the parent under section 161.001(f)(1) of the Texas Family

Code.” Section 161.001(f), which became effective September 1, 2023, provides:

In a suit for termination of the parent-child relationship filed by the Department of Family and Protective Services, the court may not order termination of the parent-child relationship under Subsection (b)(1) unless the court finds by clear and convincing evidence and describes in writing with specificity in a separate section of the order that:

(1) the department made reasonable efforts to return the child to the parent before commencement of a trial on the merits and despite those reasonable efforts, a continuing danger remains in the home that prevents the return of the child to the parent[.]

Tex. Fam. Code Ann. § 161.001(f)(1). In its termination order, the trial court made

the following findings:

58 Termination Order

…

7. Reasonable Efforts to Return the Child

7.1. The Court finds by clear and convincing evidence that the Department made reasonable efforts to return the child, [TIM], to the parent. However, despite those reasonable efforts to return the child, [TIM] home to the parent, a continuing danger remains in the home that prevents return.

7.2. The Court specifically finds that those reasonable efforts include the following:

7.2.1. The Department created a family service plan that is narrowly tailored to address any specific issues identified.

7.2.2. The Department made a referral for services, provided services, or paid for services.

7.2.3. The Department made the following additional reasonable efforts to return the child home to the parent: The Department provided for visitation between the mother and child; The Department placed the child with the mother and attempted to conduct a monitored return home of the child with the mother.

8. Termination of Respondent Mother[‘s] Parental Rights

8.4. In accordance with §161.001(c), Texas Family Code, the Court finds that the order of termination of the parent child relationship as to [Mother] is not based on evidence that [Mother]:

8.4.2. is economically disadvantaged;

…. 59 8.4.6. sought an opinion from more than one medical provider relating to the child’s medical care, transferred the child’s medical care to a new medical provider, or transferred the child to a new health care facility;

8.4.8. refused… to consent to… psychiatric or psychological treatment of the child, unless the refusal:

8.4.8.1. presents a substantial risk of death, disfigurement, or bodily injury to the child; or

8.4.8.2. results in an observable and material impairment to the growth, development, or functioning of the child[.]9

Section 161.001(f)

We have not had occasion to address the requirements of Texas Family Code

section 161.001(f). We agree with our sister court that although the phrases

“reasonable efforts” and “continuing danger” can be found elsewhere in the Code,

“we are unaware of any provision of the Texas Family Code that uses ‘continuing

danger’ in the same manner as it is used in section 161.001(f), particularly under the

relevant evidentiary standard: clear and convincing evidence.” In the Int. of T.R.,

9 The trial court’s Findings of Fact and Conclusions of Law are identical to the findings in the termination order except that the finding regarding the monitored return states: “The Department placed the child with the mother and attempted to conduct a monitored return home of the child with the mother that was unsuccessful because of the continuing danger to the child while placed with the mother.” (Emphasis added). 60 No. 01-25-00924-CV, 2026 Tex. App. LEXIS 3275, at *37 (Tex. App.—Houston

[1st Dist.] Apr. 9, 2026, no pet. h.) (mem. op.).

As it did in In the Int. of T.R., the Department argues on appeal that the

meaning of the word “danger” in subsection (f)(1) can be derived from case law

interpreting the word “endanger” in subsections (b)(1)(D) and (b)(1)(E) regarding

predicate grounds for termination. See id. at *37-38; Tex. Fam. Code Ann. §

161.001(b)(1)(D), (E). While such case law may prove informative, “we cannot stop

there[,]” because “[s]ection 161.001(f) requires that the danger (1) be ‘continuing,’

(2) ‘remain[] in the home,’ and (3) ‘prevent[] the return of the child to the parent.’”

In the Int. of T.R., 2026 Tex. App. LEXIS 3275, at *38 (quoting Tex. Fam. Code

Ann. § 161.001(f)).

Section 161.001(f) describes the danger that must exist in order to terminate

the parent-child relationship. We “presume the Legislature included each word in

the statute for a purpose[.]” In the Int. of M.N., 262 S.W.3d 799, 802 (Tex. 2008)

(citing Eddins-Walcher Butane Co. v. Calvert, 298 S.W.2d 93, 96 (Tex. 1957)).

“[W]e interpret statutes under the assumption that the Legislature tries to say what

it means, therefore, the plain language of the statute is ‘the surest guide to legislative

intent.’” Presley v. Gulf States Utils. Co., No. 09-10-00039-CV, 2010 Tex. App.

LEXIS 8668, at *15-18 (Tex. App.—Beaumont Oct. 28, 2010, pet. denied) (quoting

Fitzgerald v. Advanced Spine Fixation Sys., Inc., 996 S.W.2d 864, 865-66 (Tex.

61 1999)). “[W]hen we stray from the plain language of a statute, we risk encroaching

on the Legislature’s function to decide what the law should be.” Fitzgerald, 996

S.W.2d at 866.

First, the statute uses temporal language requiring the State to prove a

“continuing” danger that “remains” despite reunification efforts. See Tex. Fam.

Code Ann. § 161.001(f)(1). While we acknowledge that a parent’s pattern of prior

conduct may permit an inference that such conduct might continue in the future, we

also agree with our sister court that section 161.001(f) focuses on the parent’s

“recent history and engagement, or lack thereof, with the Department and its

reunification efforts.” In the Int. of M.N.M., 708 S.W.3d 321, 332 (Tex. App.—

Eastland 2025, pet. denied) (emphasis added); see also In the Int. of T.D.-B., No. 06-

25-00054-CV, 2025 Tex. App. LEXIS 9783, at *43 (Tex. App.—Texarkana Dec.

19, 2025, pet. denied) (mem. op.) (Rambin, J., dissenting) (“[T]o give effect to

‘continuing,’ what has happened before should be attenuated by what has happened

since, and a greater emphasis should be placed on the circumstances at the time of

the final hearing.”). Therefore, although conduct and circumstances in the distant

past may be relevant, the plain language of the statute requires the trial court to pay

particular attention to more recent conduct and circumstances existing in the time

period after removal, during reunification efforts, and leading up to the

“commencement of a trial on the merits[,]” to determine whether the State has met

62 its burden to prove by clear and convincing evidence that “a continuing danger

remains[.]” See Tex. Fam. Code Ann. § 161.001(f)(1).

Secondly, the statute uses locational language requiring proof of a danger “in

the home[.]” See id. The plain language of the statute directs the trial court’s

attention to evidence regarding the circumstances and conditions existing in the

parent’s home during the relevant time frame to determine whether the State has met

its burden to prove by clear and convincing evidence that despite reasonable

reunification efforts “a continuing danger remains in the home[.]” See id.

Lastly, the statute uses qualitative language indicating the danger must be

such that it “prevents the return of the child to the parent.” See id. This phrase directs

the trial court’s attention to evidence regarding the degree of danger as well as

evidence linking the danger to the parent. According to the plain language of the

statute, before the parent-child relationship may be terminated, the trial court must

find that the State has proven by clear and convincing evidence that returning the

child to the parent is not a viable option.

Tim’s Medical Condition and Removal Against Medical Advice

The Department argues the evidence is sufficient to establish a continuing

danger due to Tim’s medical condition. The Department claims, “Despite admitting

[Tim] was violent and potentially homicidal and his diabetes was life-threatening,

[Mother] demonstrated a pattern of refusing treatment for him, withheld medical

63 supplies from him just two months prior to trial, recited incorrect medical

requirements for him at trial, and admitted she did not know his current target

glucose or medications.”

Regarding medical supplies, Duran testified that when the boys were placed

with Mother for monitored return in July 2025, Mother arranged for Tim’s medical

supplies to be delivered to her home, but after Tim was placed with Hailey following

his discharge from inpatient psychiatric hospital in August 2025, Hailey reached out

to Duran to see if she could get the Dexcom readers from Mother since Tim was

running out. Duran testified, “[I]t took me a week to get those Dexcoms.” She

explained that she originally asked Mother to communicate directly with Hailey

about the Dexcoms, but Duran ultimately picked up the Dexcoms from Mother at

work and delivered them to Hailey. When asked why this became necessary, Duran

testified:

A. From my understanding, there -- they were not meeting with each other’s schedule. I said, “Okay, that’s fine. Let me go ahead and take care of it.” So that’s what happened.

Q. Okay. So based on what you understand, there was a conflict in the schedule between the two of them?

A. Yeah. From my understanding, yes.

Q. Okay. They both work, correct?

A. Correct.

64 The evidence is legally insufficient to enable a reasonable factfinder to form

a firm belief or conviction that a continuing danger remains in the home preventing

Tim from being returned to Mother based on the Department’s assertion that Mother

“withheld medical supplies from [Tim] just two months prior to trial.”

The record also does not support the Department’s claim that Mother did not

know Tim’s “target glucose or medications.” When asked to list the medications

Tim was taking when he went to UT Health, Mother listed Jornay, Adderall,

Vyvanse, Risperidone and Intuniv. No witnesses testified otherwise, and there are

no medical records from that time frame. When asked for her understanding

regarding a normal range for Tim’s glucose levels, Mother testified, “his target is a

hundred but with Type 1 diabetes you…” at which time a non-responsive objection

was lodged. Mother also testified she understood 70 to be too low, and 300 to be too

high. Mother’s testimony is largely consistent with the medical records which

contain a graphic display of Tim’s continuous glucose monitoring readings with the

“Target Range” listed as 70-180, with 50 labeled “below low threshold[,]” and with

350 labeled as “above high threshold[.]” If anything, Mother’s understanding of a

slightly narrower range of numbers could encourage her to seek medical intervention

sooner rather than later. The only other witness who provided any testimony on the

subject was Jefferson Rampy, the paramedic who testified, “Anywhere between 80

and 120 is considered normal levels.”

65 Our need to resort to the medical records and a paramedic’s testimony for

information about Tim’s low, high and target blood-glucose levels exposes a more

significant problem for the Department with respect to its broader assertions that

there is a continuing danger to Tim due to Mother’s medical neglect or

mismanagement: the Department did not present any competent expert evidence that

if Tim were returned to Mother, he would be in medical danger. Instead, the

Department relies on evidence that Tim has experienced blood-sugar spikes while

in Mother’s care, from which evidence we are essentially asked to infer not only that

Mother was the cause of the blood-sugar spikes, but also that if Tim were returned

to Mother she would continue to cause more spikes in the future and that Tim will

be in significant medical danger as a result. There are at least two problems with the

inference advocated by the Department: first, the evidence does not support the

Department’s premise that Tim experienced significant medical issues only while in

Mother’s care, and secondly, even if the Department’s premise were true, or even

generally true, evidence of association is not evidence of causation. See Merrell Dow

Pharm., Inc. v. Havner, 953 S.W.2d 706, 724 (Tex. 1997). “The general rule has

long been that expert testimony is necessary to establish causation as to medical

conditions outside the common knowledge and experience of jurors.” Guevara v.

Ferrer, 247 S.W.3d 662, 665 (Tex. 2007) (discussing medical conditions allegedly

caused by an auto accident). On the other hand, “the causal connection between some

66 events and conditions of a basic nature (and treatment for such conditions) are within

a layperson’s general experience and common sense.” Id. at 668. Synthesizing the

general rule and its exceptions, the Court in Guevara reaffirmed that “competent

evidence is required to prove the existence and nature of a condition and a causal

relationship to the event [in question] even though, in limited circumstances, the

existence and nature of certain basic conditions, proof of a logical sequence of

events, and temporal proximity between an occurrence and the conditions can be

sufficient to support a [fact-]finding of causation without expert evidence.” Id. at

667.

While the existence of type 1 diabetes as a serious condition is within the

common knowledge of most laypeople, the specifics of how to manage the condition

and avoid blood-sugar highs and lows are not. Nor are the differences between, and

risks associated with, hyperglycemia, ketosis and diabetic ketoacidosis. Most

importantly, the ordinary layperson does not know the various reasons that a type 1

diabetic may experience an elevated blood-glucose level requiring medical

treatment. The records indicate Tim’s blood-sugar spikes occurred sporadically over

the course of several years, sometimes when he had been left with a family member.

According to the records, “Infection or illness may cause the body to produce certain

hormones that work against insulin and may trigger an episode of DKA. Other

possible triggers include stress, physical or emotional trauma, high fever, surgery,

67 alcohol or drug abuse.” The medical records reveal some of Tim’s blood-sugar

spikes may have been related to Omnipod malfunctions, Tim’s non-compliance due

to “diabetic burnout” or sneaking late-night snacks while playing video games, and

others may have been due to inadequate supervision or lack of refrigeration of insulin

while Mother was homeless.10 The records do not express causation opinions based

on reasonable medical probability, but only the “possible” causes that were

“thought” or “suspected” by the medical professionals to be the culprit. “When the

evidence offered to prove a vital fact is so weak as to do no more than create a mere

surmise or suspicion of its existence, the evidence is no more than a scintilla and, in

legal effect, is no evidence.” Kindred v. Con/Chem, Inc., 650 S.W.2d 61, 63 (Tex.

1983). “In cases requiring clear and convincing evidence, even evidence that does

more than raise surmise and suspicion will not suffice unless that evidence is capable

of producing a firm belief or conviction that the allegation is true.” In re K.M.L., 443

S.W.3d 101, 113 (Tex. 2014). Without expert testimony, there is no competent

evidence of a causal link between Mother’s conduct and Tim’s blood-sugar spikes.

The records include the physicians’ admonitions to Mother and Tim about a

range of medical conditions that might possibly result from elevated blood-glucose

levels, but the records do not indicate which conditions are reasonably probable, nor

The trial court’s termination order states it is not based on evidence of 10

Mother’s economic disadvantage. 68 is there sufficient evidence to meet the heightened standard requiring clear and

convincing evidence. There is no question Tim faces potential dangers from his

medical condition. But whatever may be inferred from the medical records and lay

witness testimony, we conclude the evidence is insufficient to enable a reasonable

factfinder to form a firm belief or conviction that Mother was the cause of any such

danger.

The Department also claims Mother exposed Tim to medical danger by

removing him from hospitals against medical advice. There was no medical

testimony to that effect. Instead, we are apparently asked to make at least two

inferences: first, that leaving against medical advice is always dangerous, and

secondly, that since Mother has done so in the past, she will do so in the future

despite her compliance with the family service plan which the trial court found was

“narrowly tailored to address any specific issues identified.”11 We conclude that the

Department failed to provide medical testimony or other clear and convincing

evidence Tim would face a continuing danger due to Mother’s alleged propensity to

remove him against medical advice in the past. In reaching this conclusion, we

considered each of the seven instances the Department relies on as evidence that

11 One of those issues was that Mother “has difficulty understanding that she is putting her children at risk with their health when she removes them from the hospital without full treatment[.]” 69 Mother’s pattern of removing Tim against medical advice constitutes a continuing

On December 5, 2018, Mother removed Tim from TCH The Woodlands

because she perceived it was taking too long for a doctor to see Tim. She told the

staff that she would take Tim to Memorial Hermann, and Memorial Hermann later

confirmed that she did. After Memorial Hermann discharged Tim, Mother continued

to monitor Tim’s condition and called TCH’s endocrinology department, followed

their advice, and took Tim to TCH West Tower where Mother “yelled” at the staff

because she perceived they were not checking his blood-sugar levels often enough.

Even when viewed in the light most favorable to the trial court’s findings, this is not

clear and convincing evidence of a continuing danger. Moreover, the trial court

specifically did not consider Mother’s transferring Tim from one medical facility to

another as evidence supporting termination. Therefore, the hospital visits on

December 5, 2018, do not support the trial court’s finding under section 161.001(f).

On June 23, 2019, Mother took Tim to the emergency room in Kingwood but

left against medical advice after about an hour because she perceived it was taking

too long. Mother and Tim arrived at TCH The Woodlands thirty-four minutes later.

Once again, these hospital visits do not support the trial court’s finding under section

161.001(f).

70 On June 15, 2023, Mother had Tim transported to TCH West Tower because

she was concerned about his mental health. The hospital recommended that he be

admitted to an inpatient psychiatric facility. He was medically cleared, but twenty-

two hours later no facility had accepted him, so Mother removed him from the

hospital against medical advice. In the absence of expert testimony, and because Tim

was medically cleared, there is insufficient evidence that Tim was at “substantial

risk of death, disfigurement or bodily injury” nor that removing Tim “result[ed] in

an observable and material impairment to the growth, development, or functioning

of the child[,]” without which Mother’s refusal to consent to psychiatric care was

not considered as evidence supporting termination according to the trial court’s

termination order. Therefore, Mother’s removing Tim on June 16, 2023, does not

support the trial court’s finding under section 161.001(f).

On October 9, 2024, Tim was transported to TCH The Woodlands out of

concern for his mental health. Inpatient psychiatric care was recommended, and

Mother initially agreed, but she later refused consent to transfer Tim because she

believed the psychiatric facility was related to TCH. Tim had been medically cleared

by that time, and there is no competent evidence that Tim faced a “substantial risk

of death, disfigurement or bodily injury” nor is there competent evidence that

Mother’s removing Tim “result[ed] in an observable and material impairment to the

growth, development, or functioning of the child.” Moreover, although the

71 Department criticizes Mother for not following through with inpatient psychiatric

care for Tim on October 9, 2024, there is no evidence the Department sought any

such care for Tim two weeks later when it removed Tim from Mother’s care and

became Tim’s temporary managing conservator. In fact, no such care was

implemented until August 2025, and that was done at Mother’s request, rather than

the Department’s. We conclude Mother’s removing Tim on October 10, 2024, does

not support the trial court’s finding under section 161.001(f).

This leaves June 8, 2020, July 9, 2021, and September 8, 2024, as the instances

of Mother’s removing Tim against medical advice that may have been considered

by the trial court to support its findings under section 161.001(f). However, there is

no evidence Mother’s removing Tim from the hospital on these three occasions (or,

for that matter, any of the other four occasions) posed any significant danger to Tim’s

health. Mother testified Tim was always okay after they left a hospital, a self-serving

statement the trial court was free to disbelieve, but there is no testimony or medical

record indicating that Tim ever experienced any adverse consequences after being

removed against medical advice, and no witness, expert or otherwise, testified Tim

was ever in any danger as a result of being removed from a hospital. Without such

evidence, there is no evidence of a danger in the recent past from which a continuing

danger could be inferred.

72 In addition to the seven instances cited by the Department, the Department

cites the opinions of lay witnesses who testified that Tim would face a continuing

danger due to Mother’s propensity to remove him from hospitals against medical

advice. But the lay opinions suffer from the same problem: four of the seven

removals are not to be considered in the analysis, and there was no evidence any of

the seven removals actually endangered Tim. Moreover, none of the lay witnesses

was shown to have any qualifications upon which to base such an opinion. “Bare,

baseless opinions will not support a judgment even if there is no objection to their

admission in evidence.” City of San Antonio v. Pollock, 284 S.W.3d 809, 816 (Tex.

2009). Since we are not required to accept the ipse dixit of a credentialed witness,

we certainly are not required to accept the ipse dixit of witnesses who have not been

shown to have any credentials but who, nevertheless, express opinions requiring

medical expertise. See id. at 818. We conclude the evidence is legally insufficient to

enable a factfinder to form a firm belief or conviction that a continuing medical

danger remains in the home that prevents Tim’s return to Mother.

Tim’s Behavior

The Department argues the evidence is sufficient to establish a continuing

danger because Mother “remained unable to handle [Tim’s] behaviors[.]” Under

cross-examination, Duran testified:

73 Q. [MOTHER’S TRIAL COUNSEL]: Okay. So what is it about my client as of today, snapshot, that would indicate that she is a continuing danger to this child?

A. She is not able to handle the behavior when he gets to the point where he’s being very aggressive.

Q. So who’s the dangerous one? Is it my client, or is it [Tim]?

Duran’s question, “[W]hat is provoking [Tim]?” was never answered. Duran

apparently did not know, and neither do we. The Department did not provide any

expert testimony that would enable a factfinder to determine the cause of Tim’s bad

behavior. Instead, the Department essentially asks us to infer Mother was the cause,

because according to the Department, Tim “only exhibited negative behaviors… in

[Mother’s] care[.]” But the undisputed evidence shows Tim exhibited negative

behaviors at school, at the hospital, with a foster parent in 2022, and with Hailey

(pushing) and Duran (flinging her arm) during the pendency of this case. The

Department’s assumption that Mother is the cause of Tim’s bad behavior fails to

consider that Tim’s behavior may be influenced by factors unrelated to Mother,

including a pattern of abuse directed at Mother and the children on the part of Tim’s

father, the death of Tim’s father, the fact that Tim must live with a chronic disease

that requires diligent monitoring and regulation of food intake and medicine, Tim’s

learning difficulties, and adolescence.

74 Dr. Salmeron’s Psychological Report from January 2025 identifies several

possible causes. According to the report, “Tim is functioning four years below

expectation as compared to other children in his age range, suggesting handwriting

and written organizational skills are developing at a slower pace than same age

peers.” “[L]earning differences coupled with uneven processing place [Tim] at risk

for gaps in confidence, especially in the classroom (contributing factor to behavior

problems)[.]” Tim showed signs of “underlying stress[,]” “repressed dysphoria and

loss[,]” “powerlessness in relational situations[,]” and “low self-esteem[.]” “Test

data point to risk factors for self-defeating relational habits over time (boundary

regulation problems; argumentative with the teacher; patterns of

domination/submis[s]ion).” Dr. Salmeron’s report indicates, “[P]roduction fatigue

may affect [Tim’s] school performance (contributing to low motivation, inattention

or disruptive behavior).” Dr. Salmeron’s diagnostic impressions were: “Other

Specified Trauma Related Disorder[,] Attention Deficit Hyperactivity Disorder, By

History[,] Specific Reading Disorder[,] Specific Mathematics Disorder[,] Specific

Disorder of Written Expression[,] Rule Out Mixed Receptive Expressive Language

Disorder[,] Neglect of a Child, By Report[.]” None of the possible causes of Tim’s

misbehavior is stated in terms of reasonable psychological probability. Much of the

report is subject to interpretation, and not within a layperson’s common knowledge

and experience. See In re K.M.L., 443 S.W.3d at 113; Guevara, 247 S.W.3d at 665-

75 66. We conclude that Dr. Salmeron’s report does not enable a factfinder to form a

firm belief or conviction that Tim’s bad behavior was caused by Mother.

We know from the Permanency Reports that Tim was receiving individual

therapy as of March, and life skills and family therapy as of July, but Dr. Salmeron’s

report recommends fifty-six “School-Based Recommendations[,]” that should be

considered by school personnel, forty-four “Home-Based Recommendations” that

should be considered by caregivers, six “Specific Strategies for ADHD[,]” and

thirty-three “Supplementary Behavior Management Strategies[.]” Dr. Salmeron did

not testify. Nor did Jeremy Factors, whom Tim was seeing weekly for individual

therapy as of March 2025, nor Charlotte Davis, whom Tim was seeing bi-weekly for

individual and family therapy as of July 2025. Nine months passed from the time of

Dr. Salmeron’s report to the time of trial, and during that time, the Department was

Tim’s temporary managing conservator. Aside from the individual and family

therapy mentioned in the Permanency Reports, there is no evidence that any of the

other therapies or strategies suggested by Dr. Salmeron were ever tried at any time

before placing the boys back with Mother for a monitored return in July 2025. 12

The Department expressed concern about Mother’s parenting skills in the

family services plan, and Mother substantially complied with the services that were

According to Hailey’s testimony Tim completed behavioral classes at school 12

on October 31, 2025, but there is no testimony indicating when those classes began. 76 tailored to address that concern, so much so that the Department placed both children

with Mother for a monitored return in late July 2025. Things went well at first, but

then the boys fought, Tim climbed onto the roof, 911 was called, and Tim was taken

to the hospital and then released. Those medical records are not in evidence. Days

later, Mother took a computer cord away, Tim grabbed a knife, Mother called 911,

and at Mother’s request, Tim was admitted for inpatient psychiatric care. Tim was

discharged by the hospital ten days later. Those records are also not in evidence.

The Department did not provide any evidence in the form of records or

testimony from a psychiatrist, psychologist or other mental health professional that

Tim was a danger to himself or others at any point after he received inpatient

psychiatric treatment and was discharged by the psychiatric hospital in August 2025.

We don’t know anything about what happened at the psychiatric hospital. Maybe a

diagnosis was made, and perhaps effective medicines or therapies were administered

or prescribed. We don’t know, nor did the trial court, because no such evidence was

provided. What we do know is that Mother had only six hours of further interaction

with Tim after his inpatient psychiatric care, and during those interactions, the only

incidents reported by Duran were an argument over whether Tim could take a phone

to Hailey’s house, and a fight in which Tim slapped and punched Chris despite

Duran’s and Mother’s efforts to stop him. Fighting between siblings is fairly

common in many households. Without more, it is not a “solid and substantial

77 reason[]” for terminating a parent’s rights. See Wiley, 543 S.W.2d at 352. No witness

testified from personal knowledge that the brothers ever resorted to weapons when

fighting each other. 13 Rather, Mother reported that Tim grabbed a knife while

arguing with Mother, and Chris hit Mother with a broomstick and used a knife to

stab a mattress and the walls during Tim’s hospitalization. The record reveals that

whenever things had escalated to that level in the past, Mother called 911. Duran

and Lee both agreed that Mother’s reaching out for help when needed was the right

thing to do, but they also both expressed concerns that things got to the point where

911 had to be called. However, these witnesses were not shown to have any mental

health qualifications, and their “concerns” about what may have been triggering

Tim’s outbursts do not constitute competent evidence that Mother was to blame.

According to the records, Tim threatened to harm his brother on June 15, 2023,

and Mother was “concerned for suicidal ideation.” The evidence at trial also showed

that on October 9, 2024, Tim got upset, fought with Chris and threatened to “kill

everyone” and then himself. Tim’s conduct on these occasions is not to be

minimized, and the record indicates Mother took his threats seriously and sought

help before deciding not to consent to inpatient psychiatric care on those occasions

13 Stocks expressed a “belie[f]” that Tim had pulled a knife on Chris, but he was not testifying on personal knowledge, and there is no other mention of a knife in the physical altercation in early October 2024 that led to Stocks’s involvement. 78 due to delay in placement or mistrust of TCH. 14 However, the evidence is legally

insufficient to enable a factfinder to form a firm belief or conviction that Mother

caused Tim’s behavior on these occasions. The evidence does indicate Tim’s

grabbing a knife in August 2025 was in response to Mother’s taking away a

computer cord after Tim did not obey her instructions to get off the computer, but

there is no evidence that Mother’s doing so was in any way improper. Without

legally sufficient evidence that Tim’s bad behavior was caused by improper conduct

on the part of Mother, the Department failed to establish by clear and convincing

evidence that any continuing danger posed by such behavior “prevents the return of

the child to the parent” as required by section 161.001(f).

The Department’s Other Concerns

At trial, the Department’s witnesses expressed several “concerns,” but when

they were specifically asked to list continuing dangers, their responses fell into two

general categories: (1) Mother neglected or mishandled Tim’s medical condition

including removing him from hospitals; (2) Mother was unable to handle Tim’s and

Chris’s behavior which includes fights between the boys and threating behavior

directed at Mother. On appeal, however, the Department claims several other

concerns amount to continuing dangers. We address each of these below.

Again, the trial court’s termination order states it is not based on evidence 14

of Mother’s refusal to consent to psychiatric care. 79 Educational Needs

The Department argues a continuing danger remains in the home because

Mother is unable to meet Tim’s educational needs. According to the Department,

Mother “admitted [Tim] was not attending school during the monitored return two

months before trial.” The monitored return began in late July, and in mid-August

Tim was admitted for inpatient psychiatric care. Tim’s lack of school attendance

while in the psychiatric hospital in August 2025 is not clear and convincing evidence

of a continuing danger that prevents Tim’s return to Mother. Nor is the fact that Tim

attended multiple schools over the years. Mother testified she was trying to find a

school that would meet Tim’s specific educational needs, and although the trial court

may have disbelieved this self-serving testimony, the Department did not introduce

any evidence from an educator or otherwise that Tim’s attending multiple schools in

the past constituted a continuing danger that prevents his return to Mother. The only

educator to testify, Sheldon, testified in Mother’s favor.

Criminal Liability

The Department argues a continuing danger remains in the home because

Mother “lied to officers about [Tim] assaulting her, and repeatedly subjected [Tim]

to potential injury, removal, and criminal liability, including just two months before

trial.” The Department’s witnesses agreed it was appropriate for Mother to call 911

when Tim’s behavior escalated to the point that he was a danger to himself or others.

80 It is unclear why the Department takes the opposite position on appeal. Mother’s

decision to call 911 on the occasions in question do not constitute clear and

convincing evidence of a continuing danger that prevents Tim’s return to Mother.

Mother’s Requests for the Department to Take the Children

The Department argues a continuing danger remains in the home because

Mother “admitted she could not care for [Tim] and asked the Department to pick

him up at the time of removal and again just prior to trial.” Regarding the statement

at the time of removal, Stocks testified Hernandez told him that Mother wanted law

enforcement to pick up the children. When Hernandez was asked if she “heard

somewhere” that Mother “wanted CPS to take the children[,”] she responded, “Yes.”

But Sergeant Sheffield could not recall Mother’s saying she wanted CPS to take the

children, only that “it was enough for me to believe that she just couldn’t handle the

chaos of the situation.” Audio was played in which Mother could be heard saying “I

want [the Department] to take these kids. I can’t deal with this anymore.” The fact

that Mother made such a statement in October 2024, while she was homeless and

before she substantially complied with the family service plan, is too remote to

constitute clear and convincing evidence of a continuing danger at the time of trial

in October 2025, as required by section 161.001(f). Regarding Mother’s statement

“just prior to trial[,]” Duran testified that Mother called her on August 11, saying

that Tim was “having another episode.” Tim was destroying property, screaming,

81 yelling, cussing and hitting her. Mother was crying and “asking if I could come pick

him up, that she couldn’t do this anymore.” Days later, upon Mother’s request, Tim

was admitted for inpatient psychiatric care. As indicated above, there is no evidence

Tim’s emotional outburst was caused by any improper conduct on the part of

Mother, nor can we find fault with Mother’s requests for assistance from the

Department and mental health professionals under the circumstances. Without

evidence establishing Mother was the problem, evidence that Mother was

exasperated to the point of requesting help from the Department or mental health

professionals is legally insufficient to establish “a continuing danger in the home”

preventing Tim’s return.

Mother’s Impairment

The Department argues a continuing danger remains in the home because “Dr.

Stadler noted that [Mother] experienced severe impairment even on medication,

which placed her at risk for neglectful parenting.” Dr. Stadler did not testify. Her

report, only part of which is quoted above, relates inconsistent and conflicting test

results, uncertain diagnoses, unknown causation, and the need for further evaluation.

According to the report, “the risk of neglectful parenting… is related to the risk of

relapse.” There is no evidence of any such relapse in this case. After an initial drug

screen on October 29, 2024, was positive for methamphetamine in the hair, there is

no evidence in the record that Mother tested positive again for controlled substances,

82 and the Department has not argued Mother’s past drug use constituted a continuing

danger at the time of trial. Dr. Stadler’s report also mentions a risk related to

Mother’s “impairments in attention, memory, and executive functioning which

likely lead to disorganization and impulsive, and possibly poor, decision-making.”

But the magnitude of this “risk” is not quantified, and Dr. Stadler’s own report

questions several of the findings regarding Mother’s cognitive abilities. Dr. Stadler’s

opinions, such as they are, are not stated in terms of reasonable psychological

probability. Much of the report is subject to interpretation, amounting to no more

than surmise and suspicion since psychology is outside a layperson’s common

knowledge and experience. See In re K.M.L., 443 S.W.3d at 113; Guevara, 247

S.W.3d at 665-66. There is nothing in Dr. Stadler’s report that would enable a

factfinder to form a firm belief or conviction that Mother is so intellectually

challenged that she is a continuing danger to her children. The Department’s

argument to the contrary is inconsistent with the Department’s decision to nonsuit

the case regarding Chris and allow Chris to remain in Mother’s care.

The Department’s Case Law

The Department cites several cases as support for its arguments that the

evidence is legally sufficient to support the trial court’s section 161.001(f) findings.

Some of the cases were decided before section 161.001(f) became effective and

address endangerment under subsections (D) and (E) of section 161.001(b)(1). These

83 are cited in support of the Department’s argument that endangerment cases inform

the meaning of the phrase “continuing danger.” As indicated above, we agree such

cases, while not controlling, may be informative. Other cases involve findings,

affirmed on appeal, of “continuing danger” under section 161.001(f). We find each

of these cases to be distinguishable on the facts as explained below:

In re J.H., No. 01-25-00854-CV, 2026 Tex. App. LEXIS 3352, at *47-55 (Tex.

App.—Houston [1st Dist.] Apr. 10, 2026, no pet. h.) (mem. op.). The parents had

incarcerations, instability, and a history of positive drug tests for the parents and

children. The court of appeals held that the parents’ history of instability, positive

drug tests, disregard for court orders, and incarceration demonstrated a continuing

danger in their home and was sufficient under 161.001(f).

R.C. v. Tex. Dep’t of Fam. & Protective Servs., No. 03-25-00890-CV, 2026

Tex. App. LEXIS 2010, at *24-27 (Tex. App.—Austin Mar. 4, 2026, no pet. h.)

(mem. op.). In this case, Mother had substance abuse problems. Mother left Father

due to domestic violence, but a week later Father returned home after apologizing,

and Mother testified this was a pattern in their relationship.

In re P.Y., 731 S.W.3d 672, 685 (Tex. App.—Houston [14th Dist.] 2026, no

pet. h.). The appellate court cites Texas Family Code section 101.009 to determine

danger. “Danger to the physical health or safety of a child includes exposure of the

child to loss or injury that jeopardizes the physical health or safety of the child

84 without regard to whether there has been an actual prior injury to the child.” Id.

While we do not rely on section 101.009, we agree no actual injury is required. In In

re P.Y., the trial court held that Father’s incarceration and any other home suggested

by Father, were unsuitable due to “an endangering environment with accessible

drugs and the threat of sexual assault[,]” demonstrating a continuing danger in the

home. Id.

In re T.D.-B., 2025 Tex. App. LEXIS 9783, at *14-15. Father’s incarceration

for drug use which prevented visitation with the child, long history of drug use

during the case, and failure to show up for a drug test which resulted in a presumed-

positive drug test demonstrated a continuing danger in the home.

Conclusion Regarding Section 161.001(f)

Based on the record before us, we find the evidence legally insufficient to

support the trial court’s finding under section 161.001(f). Viewing all the evidence

in the light most favorable to the finding, and disregarding all evidence that a

reasonable factfinder could have disbelieved or found to have been incredible, we

conclude the evidence does not enable a reasonable factfinder to form a firm belief

or conviction that despite the Department’s efforts to return Tim to Mother prior to

the commencement of the trial, a continuing danger remains in the home that

prevents the child’s return to the parent.

85 We sustain Mother’s first issue; therefore, we need not address issues two,

three and four which challenge the trial court’s statutory-predicate and best-interest

findings.

Fit-Parent Presumption

In her fifth issue, Mother argues the trial court abused its discretion by

appointing the Department as Tim’s non-parent permanent managing conservator

without rebutting the presumption that Mother is a fit parent under the standards set

forth in section 153.002(b) and (c). See Tex. Fam. Code Ann. § 153.002(b), (c).

In 2025, the legislature added section 153.002(b) to include two rebuttable

presumptions which state, “In a suit between a parent and a nonparent, it is a

rebuttable presumption that: (1) a parent acts in the best interest of the parent’s child;

and (2) it is in the best interest of a child to be in the care, custody, and control of a

parent.” Id. at 153.002(b); In the Int. of T.R., 2026 Tex. App. LEXIS 3275, at *47-

48. “A nonparent may only overcome these presumptions by ‘proving by clear and

convincing evidence that denial of the relief requested by the nonparent would

significantly impair the child’s physical health or emotional development.’” In the

Int. of T.R., 2026 Tex. App. LEXIS 3275, at *48 (quoting Tex. Fam. Code Ann. §

153.002(c)).

Mother argues on appeal that the trial court’s appointment of the Department

was “an inherent natural consequence” that flowed from the trial court’s decision to

86 terminate her parental rights, but if the evidence is legally or factually insufficient to

support termination, “then as a natural consequence, the appointment of a nonparent

permanent managing conservator is also invalid.” Mother notes that this argument

is “an analysis of first impression before this court[,]” and argues we should apply

the newly enacted rebuttable presumptions in this termination case, because “since

September 1, 2025, the non-parent is now faced with the heightened standard from

preponderance of the evidence to ‘clear and convincing,’ placing conservatorship

issues on equal ground with termination.” We agree.

By its own language, the presumption provided by section 153.002 applies

only in a suit between a parent and a nonparent. The Department is not Tim’s parent.

Nevertheless, the Department argues that “in no instance could the use of the term

‘nonparent’ in the chapter 153 provisions be construed as applicable to the

Department[,]” because other sections in chapter 153 use the phrase “nonparent, a

licensed child-placing agency, or the Department.” See Tex. Fam. Code Ann. §§

153.371, 153.372, 153.373, 153.376. According to the Department, this phraseology

indicates “nonparent” is a category separate from licensed child-placing agencies

and the Department, and if the legislature had intended the presumption in section

153.002 to apply in cases filed by the Department, it would have specifically said

so, instead of merely stating that the presumption applies in suits between parents

87 and nonparents. The Department argues we should construe “nonparent” in the

broader context of the other sections in chapter 153.

The meaning of “nonparent” is not unclear; it refers to parties other than

parents. The statute does not define “nonparent.” “Unless the statute provides a

separate definition, we presume that the Legislature meant to use the ordinary

meaning of a word, with each term ‘interpreted consistently in every part of [the]

act.’” Sunstate Equip. Co. v. Hegar, 601 S.W.3d 685, 690 (Tex. 2020) (quoting Tex.

Dep’t of Transp. v. Needham, 82 S.W.3d 314, 318 (Tex. 2002)).

That said, when we to resort to other sections in chapter 153, we must include

section 153.005(b) which states, “A managing conservator must be a parent, a

competent adult, the Department of Family and Protective Services, or a licensed

child-placing agency.” Id. § 153.005(b). Tellingly, this section does not use the term

“nonparent” as if it were a category separate from competent adults, the Department

and child-placing agencies. Borrowing the Department’s interpretive tool, section

153.005(b) would have to be understood as listing three categories (competent

adults, the Department and child-placing agencies) that are distinct from the first

category, “parents.” In other words, competent adults, the Department and child-

placing agencies are not “parents;” they are “nonparents.” We also must consider

section 153.131(a) since both that section and section 153.002(b) require a court to

find that the appointment of a parent “would significantly impair the child’s physical

88 health or emotional development” before refusing to make that parent a managing

conservator. Compare id. § 153.002(b), with § 153.131(a). In light of section

153.131(a), we construe “nonparent” in section 153.002(b) to include the

Department, because sections 153.131(a) and 153.002(b) both address the same

presumption, and courts have already applied the presumption in section 153.131(a)

to original proceedings in which the Department seeks both termination and

conservatorship. See In the Int. of J.A.J., 243 S.W.3d 611, 615 (Tex. 2007)

(construing previous version of section 153.002 and concluding the trial court’s

findings “that appointment of a parent as J.A.J.’s managing conservator would not

be in his best interest because it would significantly impair his physical health or

emotional development… satisfy not only the fundamental requirement that the

court consider the best interest of the child, see [Texas Family Code section]

153.002, but also the more specific findings necessary to justify the Department’s

appointment under section 153.131.”). Because section 153.131(a) already creates a

fit-parent presumption in cases filed by the Department, and because section

153.002(b) reflects the Legislature’s decision to require clear and convincing

evidence to overcome that presumption in suits between parents and nonparents, we

reject the Department’s argument and conclude the presumption in section

153.002(b) applies in a suit between a parent and any party who is not a parent,

including the Department.

89 Section 153.002(c), also enacted in 2025, states:

(c) In a suit between a parent and a nonparent, the nonparent may overcome the presumption under Subsection (b) by proving by clear and convincing evidence that denial of the relief requested by the nonparent would significantly impair the child’s physical health or emotional development. If the court renders an order in the suit granting relief to the nonparent, the court shall state in the order:

(1) the specific facts that support the court’s finding that denying the relief requested by the nonparent would significantly impair the child’s physical health or emotional development; and

(2) the extent to which the nonparent has overcome the presumption under Subsection (b).

Tex. Fam. Code Ann. § 153.002(c). Although the trial court found in the termination

order “that the appointment of [Mother] as permanent managing conservator of the

child is not in the child’s best interest because the appointment would significantly

impair child’s physical health or emotional development[,]” the trial court did not

include “the specific facts that support the court’s finding” as required by section

153.002(c)(1). Mother timely requested findings of fact and conclusions of law, and

the trial court once again found that “appointment of [Mother] as permanent

managing conservator of the children the subject of this suit is no[t] in the children’s

best interest because the appointment would significantly impair the child’s physical

health or emotional development[,]” but once again did not include “the specific

facts that support the court’s finding” as required by section 153.002(c)(1).

90 Texas Rule of Civil Procedure 299 provides that “when one or more elements

[of a claim or defense] have been found by the trial court, omitted unrequested

elements, when supported by evidence, will be supplied by presumption in support

of the judgment.” Tex. R. Civ. P. 299 (emphasis added). Rule 298 provides that after

the trial court delivers its original findings of fact and conclusions of law, any party

may request specified additional findings or conclusions, and “[n]o findings or

conclusions shall be deemed or presumed by any failure of the court to make any

additional findings or conclusions.” Id. 298. Mother timely requested additional

findings of fact and conclusions of law, specifically requesting the trial court “to

identify the specific facts that supports (sic) the finding that denying the relief of

termination and conservatorship requested by the Department, the nonparent, would

significantly impair [Tim’s] physical health or emotional development, as required

under TEX. FAM. CODE § 153.002(c)(1).” No such additional finding was

forthcoming. Therefore, according to Rules 298 and 299, the omitted finding

required by section 153.002(c)(1) may not be supplied by presumption in favor of

the termination order. See Tex. R. Civ. P. 298, 299; Chapa v. Reilly, 733 S.W.2d

236, 237-38 (Tex. App.—Corpus Christi 1986, writ ref’d n.r.e.). In the absence of

the finding required by section 153.002(c)(1), the trial court abused its discretion in

appointing of the Department as Tim’s permanent managing conservator.

91 We sustain Mother’s fifth issue. Therefore, we need not address Mother’s

sixth issue challenging on other grounds the trial court’s appointment of the

Department as Tim’s permanent managing conservator.

Conclusion

Having sustained Mother’s first issue asserting the evidence was legally

insufficient to establish a continuing danger in the home prevents Tim’s return to

Mother, and fifth issue asserting the trial court abused its discretion in appointing

the Department as Tim’s permanent managing conservator, we reverse the trial

court’s order and render judgment that Mother’s parental rights are not terminated,

and the Department is not appointed as Tim’s permanent managing conservator.

Inasmuch as Mother is Tim’s only surviving parent and is the only person with the

rights and duties of a parent, we need not remand any portion of this case to the trial

court for any further proceedings.

REVERSED AND RENDERED.

KENT CHAMBERS Justice

Submitted on April 13, 2026 Opinion Delivered July 6, 2026

Before Golemon, C.J., Wright and Chambers, JJ.