In the Matter of the Welfare of the Child(ren) of: S. S. and S. S., Parents.

This opinion is nonprecedential except as provided by
Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA
IN COURT OF APPEALS
A25-1120

In the Matter of the Welfare of the Child(ren) of: S. S. and S. S., Parents.

Filed February 23, 2026
Affirmed
Harris, Judge

St. Louis County District Court
File No. 69HI-JV-24-16

Anne Morris Carlson, St. Paul, Minnesota (for appellant-mother S.S.)

Karl G. Sundquist, Virginia, Minnesota (for respondent-father S.S.)

Kimberly Maki, St. Louis County Attorney, Rachel L.L. Caplan, Benjamin M. Stromberg,
Assistant County Attorneys, Hibbing, Minnesota (for respondent St. Louis County Health
and Human Services)

Angela Sonsalla, Perham, Minnesota (for guardian ad litem Brittney Springer)

Considered and decided by Reyes, Presiding Judge; Harris, Judge; and Bond, Judge.
NONPRECEDENTIAL OPINION
HARRIS, Judge
Appellant challenges the district court’s order transferring custody of her minor
child to respondent, arguing that the district court erred by determining that (1) appellant
failed to correct the safety concerns that prompted the child’s out -of-home placement,
(2) appellant would be unable to correct the safety concerns under a clarified case plan,
(3) the agency made reasonable efforts to facilitate reunification, and (4) transferring
permanent legal and physical custody was in the child’s best interests. The district court’s
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findings are supported by the record, and its legal determinations reflect no abuse of
discretion. Accordingly, we affirm.
FACTS
Appellant-mother S.S. and respondent -father S.S. were married in June 2012 and
had their marriage dissolved in January 2022. Mother and father share one biological child
together, P.S. As part of their marriage dissolution, the district court awarded both parties
joint legal custody of the child, granted mother sole physical custody of the child, and
reserved parenting time with father. The district court took judicial notice of the facts
below.
2023 CHIPS Adjudication
In February 2023, the St. Louis County Public Health and Human Services
Department (the county) filed a petition alleging that P.S. was in need of protection or
services (CHIPS) under Minnesota Statutes section 260C.007, subdivision 6(3), (4), (8),
and (9) (2022). The following facts are taken from the district court’s 2023 order
adjudicating P.S. in need of protection or services.
The district court determined that P.S. was in need of protection or services under
Minnesota Statutes section 260C.007, subdivision 6(3), because of concerns surrounding
P.S.’s medical and educational needs, as well as mother’s mental health. For example,
mother “insisted that [P.S.] needed both a special education IEP and a 504 plan 1,” but the

1 “An [Individual Education Program (IEP)] is a personalized plan detailing a disabled
student’s unique educational needs and identifying necessary accommodations.” Indep.
Sch. Dist. No. 12 v. Minn. Dep’t of Educ., 788 N.W.2d 907, 909 (Minn. 2010) (citing 20
U.S.C. § 1414(d) (2006)). Section 504, which is commonly referred to as the “504 plan,”
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school district refused. Unhappy with this decision, mother transferred P.S. to another
school district and made the same request. The second school district also rejected
mother’s claim that P.S. needed special services, concluding that he “functioned well in
the school setting and did not qualify for either an IEP or a 504 plan.” Additionally, mother
displayed extreme reactions when she learned about “mild negative social interaction[s]”
between P.S. and other students at school, insisting that staff intervene and remove P.S.
from the general education setting.
Mother also frequently claimed that P.S. was bullied at school. But when the school
interviewed P.S., he described only one instance “when lots of kids had pushed to get
access to candy because they all wanted it.” P.S. added that “he had a lot of friends at
school and missed them.” Despite mother’s claim of bullying and other behavioral
concerns, the school observed nothing atypical regarding P.S. and noted that he “did not
have one behavioral write-up.” The school also reported that it saw no indication that P.S.
had “ADHD, PTSD, or sensory processing issues, and never saw any displays or evidence
of either self-harming or aggressive behaviors, despite mother’s insistence that these issues
persisted for the child.” The school’s only concern was that P.S. had 21 absences, only
five of which were excused. According to the school, the remaining 16 unexcused
absences were attributed to mother’s “ongoing perception that the child was not

“refers to the Rehabilitation Act of 1973, which prohibits programs receiving federal
financial assistance from excluding, denying benefits to, or discriminating against
otherwise qualified individuals with disabilities.” Id. A 504 plan is a document that
“typically includes a school district’s plans for compliance with the broader statutory
mandate to provide a free appropriate public education in the Individuals with Disabilities
Education Act.” Baker v. Bentonville Sch. Dist., 75 F.4th 810, 813-14 n.2 (8th Cir. 2023).
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emotionally healthy enough to be in school.” P.S. had a brief period of inpatient
hospitalization, and when he was discharged from the hospital, mother refused to re-enroll
him in school contrary to the recommendations from the child’s therapist and primary
physician. She claimed that P.S. “refused” to attend school and that his “personality had
completely changed.”
The district court also concluded that P.S. was in need of protection or services
because of mother’s inability or unwillingness to recognize typical and normal behaviors
in P.S., which exposed him to “unnecessary medications and medical interventions.”
Mother brought P.S. to the emergency room on several occasions in January 2023.
In one instance, she brought him to the ER after he “smashed [mother’s] wrist with a
toothbrush.” Then, approximately one week later, she brought him back to the ER after he
drank mouthwash one morning. She testified that, after poison control assured her the
amount of mouthwash he had ingested was harmless, she sent him to school that morning.
Later that day, she contacted the hospital’s mobile crisis team, who indicated that P.S.
needed to be seen in the ER. P.S. was pulled from school at 1:00 p.m. that afternoon and
brought to the ER.
In another instance, mother reported to the county social worker that P.S. was in the
ER the night before and that she “had to fight to keep him home.” But after contacting the
hospital, the social worker learned that mother insisted that P.S. be admitted to inpatient
treatment. Even when P.S. was discharged from the hospital, mother reported to the social
worker that medical staff recommended that P.S. continue to receive inpatient services.
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Mother’s claim was contradicted after the social worker followed up with medical staff,
P.S.’s former therapist, and P.S.’s diagnostic assessment.
Mother also interfered with P.S.’s ability to communicate independently with
medical personnel, such that it “pose[d] a serious risk of harm to the child.” During one
assessment, medical staff observed P.S. “sitting on [mother’s] lap, whispering in her ear
often, and only [speaking] about suicidal ideation and thoughts of harming mother. Mother
appeared to be encouraging the child to say these remarks.” In a separate ER visit, mother
refused to leave P.S.’s side to allow medical staff to interview him independently.
The district court next found that P.S. was in need of protection or services under
Minnesota Statutes section 260C.007, subdivision 6(8), because of mother’s emotional and
mental health. According to P.S.’s former therapist, mother “exhibited codependent
behaviors, attention-seeking behaviors, and intent to get [P.S.] placed on Social Security
Disability.” The therapist described mother as “escalating and unpredictable” and
expressed concern about P.S.’s well-being and development. P.S.’s medication-
management prescriber noted that P.S. “appears to internalize the perceived emotions of
those around him,” which included his mother. In addition, P.S.’s primary-care physician
stated, “there are so many mental health issues ongoing that I can’t tease out what [P.S.] is
like without [mother] and Grandma around.” An illustration of mother’s emotional- and
mental-health status appears in the district court’s description of mother’s visit to a public
health and human services office in Duluth. During the visit, mother “was described by
staff as being ‘amped up,’ going from ‘happy, to mad, to crying in one sentence,’ with ‘fast
speech’ and ‘talking in circles.’”
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Mother also displayed delusional and paranoia-related behaviors. For example,
mother accused her former mother-in-law of “putting all [P.S.’s] services on hold,” accused
father of “tapping into her phone lines or her Google account,” and accused P.S. of “faking”
his behaviors because father allegedly told P.S. “to make her life hard.” Mother also
complained to the Range Mental Health (RMH) crisis team that the “child protective
services investigation was a ‘conspiracy by Dad’s family.’” Mother’s paranoia about
“hacking” later included P.S. himself. In a hospital visit in late January 2023, mother
reported to ER staff that P.S. “learned to hack while at [the hospital].” Two weeks later,
mother walked into the public health and human services office in Hibbing and accused
them of hacking into her phone. In that same conversation, mother then alleged “that the
guy at Walmart is who . . . hacked her phone and that CPS in California has become
involved in her case and accessed her information.” Approximately two weeks later,
mother “placed all of her electronic devices into a safe and deposited them on a frozen
lake.”
At the time of the CHIPS trial in August 2023, the district court found that mother
“was still of the belief that her phone had been hacked, and that leaving her electronic
devices in a safe on a frozen lake was a reasonable way to get those devices into the hands
of law enforcement to elicit some form of response to the alleged ha cking.” The district
court observed that although mother attempted to seek care for P.S. by contacting the RHM
crisis team, she “sabotages those same services before they could be put in place.” It found
that mother abused medical staff and threatened to sue them to the point where the
therapist’s office had to discontinue services because of her behavior. P.S.’s former
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therapist of two years attempted to schedule a final wrap-up session with P.S. to transition
him out of her care, but mother refused this visit. Mother also cancelled meetings between
P.S. and the RMH crisis team that would provide temporary fill-in services for therapy,
alleging that P.S. had already met with them. However, mother could not provide a basis
for her belief that a meeting had already occurred. Mother also refused to accept an offer
from NorthHomes2 to continue in-school services; mother later complained to others that
this service was not made available to her.
The district court also determined that P.S. was in an unsafe environment under
Minnesota Statutes section 260C.007, subdivision 6(9), as mother subjected him to
“unnecessary medical treatments and law enforcement involvement.”
The county’s psychologist, Dr. Ries, testified that mother created an unsafe
emotional environment that placed P.S. “at risk of both medical and psychological harm.”
He explained that “a child experiencing significant medical intervention at the request of
their parent due to seemingly fabricated or inaccurately described symptomology is at risk
for long-term anxiety, depression, and trauma.” Because of mother’s beliefs regarding
P.S.’s uncorroborated behaviors, P.S. was “prescribed a notable list of psychotropic
medications including guanfacine, clonidine, risperidone, fluoxetine/Prozac, Intuniv,
Adderall, and Seroquel.” Dr. Ries testified that each medication carries significant risks
and potential side effects that place P.S. at harm when taken and not clinically necessary.

2 NorthHomes is an organization that provides Children’s Therapeutic Support Services,
specifically mental-health skills coaching.
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Dr. Ries added that unnecessary medical interventions inhibit a
child’s ability to develop a sense of self, of others, and how to
understand how the child relates to the world around them
because the child is told that he is dangerous to himself and
others when he is not, and that his experience and judgment
about people whom he ought to be able to trust, such as his
caregivers, medical providers, and law enforcement, is
inaccurate because it is inconsistent with his caregiver’s
perceptions.

Dr. Ries further testified that P.S. was placed at risk of physical harm because
“exposing a child to unnecessary medical treatments and medications exposes the child to
unnecessary harms and side effects without any benefits.” Neuroleptic medications, for
example, “are not gentle on the body or the brain.”
The district court found that mother’s allegations of P.S. expressing suicidal ideation
or engaging in self-harm were contradicted by his medical records. For example, in one of
the instances when mother brought P.S. to the ER claiming he intended self-harm or
suicide, medical staff reported that P.S. “was running around his living room and asking if
he hit his head on fireplace glass if it could kill him.” P.S. clarified that “he made the
comment that the fireplace glass could kill him if he broke it,” h owever he was “adamant
that he did not say it in a manner that he wanted to harm himself.” P.S. reported that he
had hurt himself in the past, but did so by “jumping up and dropping his body down on a
pillow.”
Mother also claimed that P.S. acted aggressively and threatened to engage in self-
harm, but she produced no corroborating evidence. The district court stated in its order
that P.S.’s “medical records do not support mother’s reports that the child engaged in self-
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injurious behaviors or self-harm.” Despite there being no corroboration, mother’s
descriptions of P.S. to medical staff from 2021 to early 2023 resulted in [P.S.] being
prescribed the list of psychotropic medications described above.
The district court found that “[m]other’s actions of repeatedly taking the child to the
emergency room for claimed emergencies and medicating the child outside of actual
medical need for such conditions/emergencies, all contribute to an immediate risk of harm
to the child, both medically and psychologically.”
In September 2023, following the CHIPS trial and based on the above factual
findings, the district court determined that P.S. was in need of protection or services and
granted the agency temporary legal and physical custody of P.S. for purposes of out-of-
home placement.
The district court also required mother and father to comply with out-of-home
placement plans. In relevant part, the case plan required mother to:
• Ensure that her medical and mental health needs are being
met by (1) completing a CHIPS Specialized Parenting
Evaluation and following all recommendations of the
evaluation; (2) demonstrating that her mental health
symptoms are stable and/or supported through
recommended treatments; and (3) signing a release to allow
the agency to ask her medical provider additional questions
and continue to follow-up on medical concerns.
• Provide a healthy home environment that meets the
emotional, mental health, and educational needs of P.S. by
(1) accepting recommendations by P.S.’s providers
regarding appointment schedules, additional services
needed, medication management, and types of therapy;
(2) cooperating with supports and service providers to
better understand P.S.’s needs; (3) not consistently looking
for worries or concerns in P.S.; (4) communicating with the
social worker via notebook regarding any updates about
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P.S.’s therapy appointments, medical appointments, or
school; and (5) participating in Intense Family Based
Services to develop parenting skills, communication skills,
learn about their family, and learn to look at difficulties
differently.
• Display the necessary cooperation, motivation, and tenacity
required for reunification by (1) allowing the agency’s
social worker to be a collateral contact for all evaluations
that are completed and (2) signing all requested releases of
information for the agency’s social worker to obtain copies
of assessments and progress notes.

After P.S. was removed from mother’s care, father began parenting-education
courses and visitation with P.S. About four months later, the agency assessed father’s
ability to be an appropriate caretaker; it determined that father did not need additional
support or services and placed P.S. under his care. Mother contested this decision,
referencing a 2020 maltreatment report where father left a bruise on P.S. as a result of a
spanking. Father later testified that he spanked P.S. as a form of discipline and that may
have left a bruise. There was no evidence that father left the bruise maliciously.
Reunification Efforts and 2024 Transfer of Custody Petition
Following the CHIPS adjudication, the agency continued its attempt to facilitate
reunification between mother and P.S while P.S. was under father’s care. Mother began
therapy and medication management, signed releases of information for the agency’s social
workers to communicate with her providers, maintained contact with the social workers,
and was consistent with her visits. However, mother had not “developed an understanding
of normal child behaviors, normal parent -child problem solving, and when and how to
appropriately seek medical or other support.” T he agency did not believe that mother
“demonstrated any understanding of the problems which led to the child’s removal from
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her care.” In March 2024, the agency filed a petition to transfer permanent legal and
physical custody to father under Minnesota Statutes section 260C.515, subdivision 4
(2022).
Parenting-Capacity Evaluation
Mother completed a parenting-capacity evaluation with Dr. Guthmiller, a licensed
psychologist, in July 2024. The evaluation indicated that mother’s behaviors are consistent
with diagnoses of “Factitious Disorder, Imposed on Another” (FDIA), somatic symptom
disorder (SSD),3 and a personal history of psychological trauma. Dr. Guthmiller testified
that FDIA “is when someone intentionally exaggerates or creates symptoms in someone
else.” This may include misreporting or exaggerating information, or “inducing or causing
injury or illness or impairment in another person . . . by a willful misrepresentation of the
clinical picture or what’s being presented. ” Both have the potential to present parenting
concerns.
Dr. Guthmiller’s evaluation explained that mother produced false information by
indicating that P.S. needed an IEP and a 504 plan, and by alleging that P.S. was physically
and sexually abused while at the hospital and was too depressed to attend school. Mother
“further engaged in the neglect of her child via withholding prescribed medications,
removing him from inpatient hospitalization against medical advice, and providing him

3 Dr. Guthmiller testified that SSD “is when there is a somatic or bodily sensation or
symptom that causes someone a lot of distress. So, that can be something like fatigue, pain,
headaches.” Dr. Guthmiller explained that these symptoms “cause more distress or
impairments in functioning than would be typically expected.” As a result, a person would
face “significant impairment” in their “ability to work, to go to school, [and] to potentially
take care of themselves.”
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with medications that she purchased online without a prescription or recommendation from
the child’s doctor.” Mother also claimed that P.S. engaged in self-harm by “pinching
himself” and “bouncing his iPad on his legs.” Documentation also identified concerns that
mother “coached” P.S. during clinical interviews. For example, medical staff observed
P.S. looking at mother when asked a question that he “does not remember.” And P.S. had
“difficulty talking without [mother’s] support.”
Dr. Guthmiller’s evaluation stated that mother’s “performance on psychological
testing measures raises concerns regarding her insight into her experience of mental health
symptoms, amenability to treatment moving forward, ability to accept feedback, and
motivation to change.”
After Dr. Guthmiller provided mother diagnoses of FDIA, the agency modified her
case plan to include treatment with an FDIA-experienced provider. However, at a pretrial
hearing in November 2024, mother indicated that there was “substantial disagreement with
[her] diagnosis of [FDIA].” As such, mother stated that she “wish[ed] to get a second
opinion through a re- evaluation to confirm ” the diagnosis. In January 2025, mother
arranged for a neuropsychological evaluation by neuropsychologist, Dr. Kearney, for the
purpose of disputing her FDIA diagnosis. Dr. Kearney indicated to mother that he “could
provide an overview of her cognitive functioning but [he] wasn’t going to be a part of
undoing [the FDIA] diagnosis.” Dr. Kearney’s subsequent evaluation addressed only
neurocognitive functioning, explicitly including a note that he told mother that he was “not
in a good position to say whether or not she truly has” FDIA.

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2025 Transfer of Custody Trial
A four-day court trial was held in the spring of 2025. The district court heard
testimony, in relevant part, from Dr. Fischer, a forensic psychologist; Dr. Tilstra, mother’s
geneticist; Dr. Ries, the agency’s consulting psychologist; Dr. Guthmiller; Dr. Kearney;
L.S., the agency’s social worker; father; mother; and the guardian ad litem (GAL).
At trial, mother disagreed with the findings and recommendations from Dr.
Guthmiller’s parenting-capacity evaluation, and much of her testimony challenged her
FDIA diagnosis. She additionally indicated that she would only be open to FDIA treatment
if the provider was also experienced in treating Ehlers-Danlos syndrome (EDS).4
Mother called Dr. Fischer to testify about his review of the evaluation prepared by
Dr. Guthmiller. He did not meet with mother or P.S.; rather, Dr. Fischer’s role was limited
to assessing the work that went into creating the evaluation itself. Dr. Fischer produced a
consultation report reviewing Dr. Guthmiller’s evaluation, and he specified in the report
that he was not providing a “second opinion” on mother’s FDIA diagnosis. Dr. Fischer
testified that his biggest concern with the parenting-capacity evaluation was that the FDIA
diagnosis may be inaccurate because there were no symptoms demonstrating a volitional
element, meaning there has to be deliberate deception of others. For example, “a person
who deliberately poisons themselves or harms themselves or feign[s] some type of illness.”
FDIA, he added, is imposed on another, meaning that parents will typically “cause[] their
children to be sick” and this “result[s] in hospitalizations and unneeded medical treatment.”

4 EDS is a “connective-tissue disorder” that can present itself in “bone disorders, tendons,
ligaments, skin conditions, sometimes vision, hearing, [and] teeth.”
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Mother also presented testimony from Dr. Tilstra, who confirmed her EDS
diagnosis and treats her for that disorder. Dr. Tilstra began evaluating mother in 2023 and
saw her on three occasions between July 2023 and October 2024. The district court found
that Dr. Tilstra neither evaluated P.S. nor identified any behavioral component of EDS that
would connect mother’s diagnosis to her decisions regarding P.S.’s medical care. Dr.
Tilstra further testified that he had been operating under the mistaken belief that mother
had been diagnosed with factitious disorder rather than FDIA. He acknowledged that he
could not offer opinions regarding FDIA and confirmed that nothing about mother’s EDS
diagnosis would have affected her parenting behavior.
Dr. Ries testified at trial. In response to mother’s assertion that her EDS and FDIA
“went hand-in-hand,” Dr. Ries stated that any connection between the two would be “very
tenuous in nature.” Addressing Dr. Fischer’s conclusion that there was insufficient
evidence of FDIA, Dr. Ries testified that FDIA is “inherently deceptive” and that the lack
of observable evidence is not necessarily dispositive. Dr. Ries further testified that,
regardless of whether mother’s behaviors were attributable to FDIA or to another condition
or contributing factor, the effect of mother’s conduct on P.S.’s safety would be the same.
The district court found Dr. Ries’s testimony “credible and compelling in light of the
overall circumstances of this case.”
The district court also heard from Dr. Guthmiller, who testified about her parenting-
capacity evaluation and provided a background on FDIA and SSD. She testified that a
parent with FDIA may over-utilize “medical services, medications that the child doesn’t
need, [and] interventions that the child doesn’t need, [which] can cause long-term
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consequences.” Consequently, the child may grow confused about “their own health, their
own body, [and] their relationship with others. They can be pulled from school and miss
opportunities to socialize, to engage in [developmentally] appropriate and important
activities.” Additionally, they can “develop their own mental health concerns,” such as
depression, anxiety, and PTSD.
Dr. Guthmiller also addressed Dr. Fischer’s testimony that her evaluation failed to
address a “volitional element.” She maintained that FDIA was a proper diagnosis for
mother and referenced examples of mother’s behavior in support, such as withholding
information from medical staff about medications she gave to P.S., exaggerating P.S.’s
statements and behaviors as suicidal ideation, coaching P.S., and expressing a desire to
seek medical care elsewhere because medical staff were not treating P.S. to her satisfaction.
The district court found Dr. Guthmiller’s testimony and evaluation well-reasoned and
credible.
L.S. joined P.S.’s case about one year after the CHIPS case opened. L.S. saw mother
and father progress in their respective out- of-home placement plans. As it relates to
mother’s plan, L.S. explained that he tried various approaches to assist mother, such as
offering several different treatment providers and scheduling family team meetings. And
when mother denied treatment claiming that her insurance would not cover the cost, L.S.
even offered to have the agency reimburse her or cover the cost. Mother insisted that her
treatment provider be specialized in EDS and FDIA, but L.S. explained to her that it would
likely be impossible to find someone with expertise in both. Regardless of the agency’s
ability to find a provider experienced in both FDIA and EDS, mother still refused to
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cooperate, asserting that she “didn’t want anyone to treat her if they accepted that FDIA
diagnosis.” L.S. testified that, in all of his interactions with mother and in reviewing Dr.
Guthmiller’s assessment, he observed no indication that mother even considered that she
made any mistakes while caring for P.S. throughout 2022 and 2023. He testified that, with
mother’s FDIA diagnosis, “safe reunification was very unlikely” so long as mother
remained “[un]able to acknowledge the harm and the issues that occurred.”
The district court also heard testimony from the GAL. The GAL testified that when
she first joined this case, in February 2023, P.S. was staying with a non-relative foster
parent for a short period but was soon transitioned into a paternal relative’s foster home.
The GAL recalled that there were some minor behavioral issues while P.S. was placed with
the relative, and that the school made no concerning reports regarding P.S.’s attendance,
behavior, or understanding of classroom material. The GAL also testified that P.S.’s
“medical, dental, mental health, [and] school needs” were generally met under father’s
care. She noticed “some minor regression” in P.S.’s behavior during mother’s visits, such
as “baby talk” and “baby actions.” However, this was not as concerning to her. But overall,
the GAL was impressed with P.S.’s growth over the past two-and-a- half years as he was
performing well in school, was not having major outbursts, and was not “self-identifying
suicidal [or] homicidal behaviors or actions.”
The GAL also testified that she was concerned about mother’s refusal to
acknowledge or accept treatment for her FDIA diagnosis. She believed that, if left
unaddressed, it would “affect [mother’s] ability to safely parent [P.S.] long-term.” While
the GAL testified that mother should still be involved in P.S.’s life, the GAL believed that
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father was “an appropriate and safe caregiver for [P.S.],” and that a transfer of custody to
father “would be in [P.S.]’s best interest.”
The district court transferred permanent legal and physical custody of P.S. to father.
Mother appeals.
DECISION
As an initial matter, father argues that mother waived her arguments on appeal
because of inadequate briefing. We note that , although mother’s brief cites to legal
authority for the standard of review and the general rules regarding transfer-of-custody
petitions, she cites no statutes or caselaw that support her claims.5 Appellate courts decline
to reach issues that are inadequately briefed. In re Civ. Commitment of Kropp, 895 N.W.2d
647, 653 (Minn. App. 2017), rev. denied (Minn. June 20, 2017). And “[a]n assignment of
error based on mere assertion and not supported by any argument or authorities in
appellant’s brief is waived and will not be considered on appeal unless prejudicial error is
obvious on mere inspection.” Schoepke v. Alexander Smith & Sons Carpet Co., 187
N.W.2d 133, 135 (Minn. 1971). While we could conclude that mother’s arguments are
waived on appeal, we nevertheless address them because we would reach the same
conclusion.
Mother argues that the district court’s findings were inadequate to support its
determination that (1) she failed to correct the safety concerns that led to the out-of- home
placement plan, (2) she was unable to meet P.S.’s needs if given the opportunity to do so

5 We need not address father’s argument because, even if we consider mother’s arguments
adequately briefed, we find those arguments would not change our conclusion.
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under a safety plan, (3) the agency made reasonable efforts to support reunification
between mother and P.S., and (4) transferring custody served the child’s best interests. We
address each argument in turn.
I. The district court did not abuse its discretion by determining that mother failed
to correct the conditions leading to the child’s out-of-home placement.

Mother first argues that the district court made inadequate findings regarding her
efforts to correct the safety concerns that led to the out-of-home placement plan.
In juvenile-protection matters challenging the transfer of permanent legal and
physical custody of a child, we review “the district court’s factual findings for clear error
and its finding of a statutory basis for the order for abuse of discretion.” In re Welfare of
Child of T.M.A., 11 N.W.3d 346, 354–55 (Minn. App. 2024) (quotation omitted). In doing
so, we “view the evidence in a light favorable to the findings” and refrain from making our
own facts, reweighing the evidence, and reconciling conflicting evidence. In re Civ.
Commitment of Kenney, 963 N.W.2d 214, 221–22 (Minn. 2021). A district court’s factual
findings “are clearly erroneous when they are manifestly contrary to the weight of the
evidence or not reasonably supported by the evidence as a whole.” Id. at 221 (quotation
omitted). “A district court abuses its discretion if it makes findings of fact that lack
evidentiary support, misapplies the law, or resolves discretionary matters in a manner
contrary to logic and the facts on record.” T.M.A., 11 N.W.3d at 355.
In permanency proceedings, a district court may transfer permanent legal and
physical custody to a parent or a “fit and willing relative.” Minn. Stat. § 260C.515,
19
subd. 4(a)(1)-(2) (2022). The district court’s transfer-of-custody order must include the
following detailed findings:
(1) how the child’s best interests are served by the order;
(2) the nature and extent of the responsible social
services agency's reasonable efforts or, in the case of an Indian
child, active efforts to reunify the child with the parent or
guardian where reasonable efforts are required;
(3) the parent’s or parents’ efforts and ability to use
services to correct the conditions which led to the out-of-home
placement; and
(4) that the conditions which led to the out- of-home
placement have not been corrected so that the child can safely
return home.

Minn. Stat. § 260C.517(a) (2022). Each of these findings must be proved by clear
and convincing evidence. Minn. R. Juv. Prot. P. 58.03, subd. 1; T.M.A., 11 N.W.3d at 355.
“A case plan that has been approved by the district court is presumptively
reasonable.” Id. at 358 (quotation omitted). “A parent’s failure to comply with a
reasonable case plan results in a presumption that the parent has failed to correct the
conditions leading to out-of-home placement.” In re Welfare of Child of J.K.T., 814
N.W.2d 76, 87 (Minn. App. 2012).
Mother does not dispute that her case plan was approved by the district court, nor
does she argue that the plan itself was unreasonable. Rather, she maintains that she
substantially complied with the plan by engaging in services offered by the agency,
including therapy and visitation, and by completing the parenting-capacity evaluation. The
district court acknowledged that mother complied with most aspects of the plan. It
nevertheless concluded that she failed to complete the plan’s central component:
20
participation in FDIA treatment. That requirement addressed the conduct that prompted
P.S.’s removal in the first place.
The record amply supports the district court’s determination that mother failed to
correct the conditions that led to removal. The district court found that L.S. credibly
testified that mother was unwilling to undergo treatment for her FDIA diagnosis and
refused to see a professional experienced in that diagnosis. Despite L.S.’s extensive efforts
to satisfy mother’s requests with respect to FDIA treatment, mother was unwilling to even
explore the possibility that FDIA was a concern and was unwilling to seek treatment from
a qualified professional unless the provider had expertise in both EDS and FDIA— a
requirement that would be difficult, if not impossible, to satisfy.
L.S. and the GAL both testified that they did not believe long-term safety for P.S.
could be established while in mother’s care if her FDIA diagnosis remained untreated. He
added that “very little” had changed since P.S. left mother’s care and that mother had not
acknowledged any harm to the child, any safety concerns to the child, or any changes she
would make as a parent if P.S. were returned to her care.
In light of this record and the deference afforded to the district court’s credibility
determinations, the district court’s factual findings were not clearly erroneous. See J.K.T.,
814 N.W.2d at 90 (stating that credibility determinations are left to the district court
because they are “in the best position to assess the witnesses’ demeanor”). And the district
court did not abuse its discretion in determining that mother failed to correct the conditions
that led to the child’s out-of-home placement.
21
II. The district court did not abuse its discretion by determining that mother could
not adequately correct the safety concerns even if a clarified safety plan gave
her the opportunity to do so.

Mother next argues that the district court abused its discretion by not affording her
another opportunity to demonstrate that she could correct the conditions leading to P.S.’s
out-of-home placement under “a safety plan with clear instructions and guidance from the
agency about what specific changes needed to be made.” According to mother, the safety
concern that prompted this CHIPS proceeding was her “frequently seeking medical advice
regarding concerns about her child.” The reasoning underlying the district court’s order,
she states, was her refusal to “embrace” the FDIA diagnosis —a diagnosis that she still
rejects. She argues that her refusal to embrace the FDIA diagnosis is not a safety concern
that prevents P.S.’s return to her care. We are not persuaded.
There was credible testimony that mother repeatedly brought P.S. to the ER for
normal behaviors and trivial concerns, often misrepresenting P.S.’s behaviors to medical
professionals. This resulted in P.S. missing school, missing opportunities to socialize with
others, and being exposed to several psychotropic medications that were medically
unnecessary and dangerous. The root cause of mother’s behaviors was her FDIA diagnosis,
which, if left untreated, would have continued to hinder P.S.’s mental, emotional, and
physical growth given the countless unnecessary medical interventions. The district court
found that mother “has never demonstrated any awareness or insight as to why [P.S.] was
removed or what needed to change.” Based on the FDIA diagnosis, we struggle to see how
placing P.S. in mother’s care—just to afford her an opportunity to see if she stops seeking
medical attention repeatedly—would be in P.S.’s best interests. As the district court’s
22
order made clear, returning P.S. to mother’s care would return him to the same unsafe and
unstable environment that led to his out-of -home placement. See J.K.T. , 814 N.W.2d at
90.
Under these circumstances, there is no indication that mother would succeed under
a safety plan clarifying when medical intervention is appropriate or not. If mother refuses
to acknowledge her FDIA diagnosis and refuses to work with a provider unless they have
expertise in both FDIA and EDS— a difficult, if not impossible likelihood—we fail to see
how mother would succeed under a clarified safety plan.
In short, the district court’s findings are well supported by record evidence, and its
legal determination was not an abuse of discretion.
III. The district court did not abuse its discretion by determining that the agency
made reasonable efforts to reunify mother and child.

Mother next argues that the district court failed to make adequate findings regarding
the agency’s reunification efforts. We review the district court’s determination that the
agency’s efforts were reasonable for an abuse of discretion. See In re Welfare of Child of
D.L.D., 865 N.W.2d 315, 323 (Minn. App. 2015) (stating that district court’s “reasonable-
efforts finding was not an abuse of discretion”), rev. denied (Minn. July 20, 2015).
When evaluating the agency’s reasonable efforts, the district court must consider
whether services to the child and family were:
(1) relevant to the safety and protection of the child;
(2) adequate to meet the needs of the child and family;
(3) culturally appropriate;
(4) available and accessible;
(5) consistent and timely; and
(6) realistic under the circumstances.
23
Minn. Stat. § 260.012(h) (2022 ). “Reasonable efforts encompass more than just a case
plan.” J.K.T., 814 N.W.2d at 88. “Reasonable efforts” require “due diligence by the
responsible social services agency to use culturally appropriate and available services to
meet the needs of the child and the child’s family.” Minn. Stat. § 260.012(f) (2022). “The
nature of the services which constitute ‘reasonable efforts’ depends on the problem
presented.” In re Welfare of S.Z., 547 N.W.2d 886, 892 (Minn. 1996).
Mother contends that the agency’s efforts were not reasonable because the agency
“did not facilitate completing another [parenting-capacity evaluation] or receiving a second
opinion” about her FDIA diagnosis. As previously mentioned, she cites no legal support
for her claim that the agency was required to facilitate a second assessment. In any event,
mother was never prevented from obtaining a second evaluation. Indeed, mother’s counsel
told the district court at a pretrial hearing in November 2024 that mother wished to get a
second opinion regarding her FDIA diagnosis. But between November 2024 and her trial
in April 2025, mother appeared to seek a second opinion, but neglected to go to a provider
that could or would provide a second opinion on the FDIA diagnosis.
Moreover, the district court found the agency provided the following services to
correct the conditions that led to P.S.’s removal and to facilitate reunification with mother:
• Child protection assessment in 2020;
• Parent Support Outreach Program (PSOP) assessment and PSOP Case
Management in 2021;
• PSOP assessment and Children’s Mental Health assessment both initiated in
January 2023;
• Child protection assessment regarding physical abuse in January 2023;
• Child protection assessment regarding educational neglect in February 2023;
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• Mental health services for [P.S.] including mental health diagnostic
assessments, individual therapy, medication management, and crisis mental
health services through the hospital emergency room;
• Acute psychiatric hospitalization;
• [Children’s Therapeutic Support Services] programming in the school;
• Crisis Mobile Team services through RMH Center;
• Numerous collateral contacts;
• Contacts with mother, the minor child, and father; and
• Clinical consultation with [the] agency psychologist.

In addition to these services, the district court specifically found that requiring
mother to participate in treatment with an FDIA-experienced provider was reasonable to
help her (1) understand how P.S. was harmed by the conditions that led to his removal ,
(2) develop empathy for P.S.’s experiences, and (3) learn new coping skills for parenting
P.S. without exhibiting the harmful patterns and behaviors that led to his removal. The
district court determined that no additional services or programs would enable mother to
parent P.S. in the foreseeable future. It stated that any additional services to support
reunification “would be futile, given mother’s continued lack of insight into the events
leading to [P.S.]’s removal and resistance to meaningful change.” After making these
findings, the district court concluded that “[t]he services provided by [the agency] to
support reunification with mother were reasonable, [the agency] complied with the
obligation to provide reasonable efforts, and [mother] did not correct the conditions which
led to the child’s out-of-home placement.”
In short, the district court’s findings are well-supported by the record, and its legal
conclusions were not an abuse of discretion.

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IV. The district court did not abuse its discretion by determining that transfer of
custody was in the child’s best interests.

Lastly, Mother seems to argue that the district court abused its discretion by failing
to consider the risks of not having court-ordered visitation between herself and P.S. She
asserts that not allowing visitation between mother and P.S. “creates potential risks to
[P.S.]’s well-being.”
“The paramount consideration in all juvenile protection proceedings is the health,
safety, and best interests of the child.” Minn. Stat. § 260C.001, subd. 2(a) (2022). This
requires the district court to consider and evaluate “all relevant factors.” Minn. Stat.
§ 260C.511(a) (2022). One factor is “the relationship between the child and relatives and
the child and other important persons with whom the child has resided or had significant
contact.” Id. (b) (2022).
We review the district court’s best-interests determination for an abuse of discretion.
See T.M.A., 11 N.W.3d at 357. A district court abuses its discretion if, among other things,
it misapplies the law or makes factual findings that lack support in the record. Id. at 355.
Here, the district court determined that transferring permanent legal and physical
custody to father was in P.S.’s best interests because returning him to mother’s care “would
place [him] in the same environment from which he was removed.” The district co urt
found that P.S. “has thrived” since being placed with father and there appeared to be “no
existing safety concerns regarding father’s home or father’s ability to provide a safe and
stable environment” for P.S. It further found that father was a suitab le legal and physical
custodian of P.S., that he understood what it meant to assume full custodial responsibility
26
of P.S., and that father was willing and able to do so. The district court noted that father
would allow P.S. to have contact with mother by phone and would permit after-school
contact as well as, potentially, some weekend and summer overnight contact. Father
supported ongoing contact between P.S. and mother’s family. These findings are supported
by the record.
Mother does not seem to contest any of the district court’s best-interest findings.
She argues only that the district court failed to address her visitation rights with P.S. Thus,
mother appears to be asserting that the district court erred by failing to make a finding of
fact that she did not ask the district court to make. However, because the district court
retains original and exclusive jurisdiction over perman ency proceedings under Minnesota
Statutes sections 260C.503-.521 (2022), mother is free to file a motion requesting visitation
with P.S. if she is not satisfied with father’s discretion in permitting visitation. See Minn.
Stat. § 260C.101, subds. 1, 2 (2022).
In sum, the district court’s best- interest findings are supported by the record, and
we discern no abuse of discretion in its conclusion that transfer of custody was in the best
interests of the child.
Affirmed.