In Re Amber R. ( 2020 )


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  •                                                                                                           12/29/2020
    IN THE COURT OF APPEALS OF TENNESSEE
    AT JACKSON
    November 17, 2020 Session
    IN RE AMBER R. ET AL.
    Appeal from the Juvenile Court for Carroll County
    No. 17-JV-7781      Larry J. Logan, Judge
    ___________________________________
    No. W2019-01521-COA-R3-PT
    ___________________________________
    In this termination of parental rights case, Appellant/Mother appeals the trial court’s
    termination of her parental rights to the minor children on the grounds of: (1) abandonment
    by failure to provide a suitable home, 
    Tenn. Code Ann. §§ 36-1-113
    (g)(1), 36-1-
    102(1)(A)(ii); (2) substantial noncompliance with the requirements of the permanency
    plan, 
    Tenn. Code Ann. § 36-1-113
    (g)(2); (3) persistence of conditions, 
    Tenn. Code Ann. § 36-1-113
    (g)(3); and (4) mental incompetence, 
    Tenn. Code Ann. § 36-1-113
    (g)(8).
    Appellant also appeals the trial court’s finding that termination of her parental rights is in
    the children’s best interests. Discerning no error, we affirm.
    Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Juvenile Court
    Affirmed and Remanded
    KENNY ARMSTRONG, J., delivered the opinion of the court, in which FRANK G. CLEMENT,
    JR., P.J., M.S., and J. STEVEN STAFFORD, P.J., W.S., joined.
    Jasmine McMackins Hatcher, McKenzie, Tennessee, for the appellant, Latoya R.1
    Herbert H. Slatery, III, Attorney General and Reporter, and Kathryn A. Baker, Assistant
    Attorney General, for the appellee, Tennessee Department of Children’s Services.
    Stephanie J. Hale, Trenton, Tennessee, guardian ad litem.2
    1
    In cases involving minor children, it is the policy of this Court to redact the parties’ names to
    protect their identities.
    2
    The guardian ad litem (“GAL”) submitted a brief adopting in full Appellee’s brief and agreeing
    with Appellee’s argument on appeal regarding termination of Mother’s parental rights. At oral argument,
    the GAL stated that the Children are doing well in a pre-adoptive home, and the GAL believed it was in the
    Children’s best interests to terminate Mother’s parental rights.
    OPINION
    I. Background
    Appellant Latoya R. (“Mother”) is the biological Mother of Amber R. (d/o/b July
    2011), Ashley Z. (d/o/b December 2013), and Andrew Z. (d/o/b October 2015) (together,
    the “Children”).3 This family has had a lengthy history with Appellee Tennessee
    Department of Children’s Services (“DCS”). As it concerns this appeal, DCS became
    involved with this family on January 5, 2017, when Mother, and her then-boyfriend, Eric
    F., reported to the Bruceton Police Department that the couple and the Children were
    homeless. Prior to becoming homeless, it was reported that Mother, Mr. F., and the
    Children lived with strangers, family, or in hotels. DCS contacted the family the day they
    reported to the police station. According to a DCS caseworker, the Children were
    appropriately dressed for the cold but had not bathed recently and had an odor. While DCS
    offered to help Mother apply for housing, Mother refused, explaining that she and her
    boyfriend were going to stay in a motel. Nevertheless, that night, DCS took the family to
    the store and purchased groceries, baby wipes, and hygiene products. DCS also offered to
    redeem Mother’s Special Supplemental Nutrition Program for Women, Infants, and
    Children (“WIC”) voucher, but she declined. On January 9, 2017, Mother contacted DCS
    stating that she ran out of food the night before. While Mother had some canned goods,
    she did not have a can opener, bowls, or silverware. Mother also informed DCS that she
    lost her WIC voucher. DCS again purchased groceries and took them to the family. On
    January 10, 2017, Mother contacted DCS stating that she would soon be out of diapers for
    Andrew; DCS took Mother diapers. While Mother consistently reported that she was out
    of food and other essential items, DCS caseworkers observed that the family had non-
    essential items, such as cigarettes.
    On January 13, 2017, DCS filed a petition to transfer temporary legal custody from
    Mother to DCS in the Juvenile Court of Carroll County, Tennessee (“trial court”). The
    petition also asked the trial court to declare the Children dependent and neglected. On
    January 31, 2017, the trial court appointed a GAL for the Children. During this time,
    Mother was also appointed counsel. On March 7, 2017, the trial court found probable
    cause that the Children were dependent and neglected “due to [Mother’s] failure to work
    with services to address her issues of instability . . . ,” and it granted DCS temporary legal
    custody of the Children. The Children were placed in DCS custody the same day. On
    April 4, 2017, Mother waived the adjudicatory hearing, and the trial court found clear and
    convincing evidence that the Children were dependent and neglected.
    3
    The record shows that Mother was married to Joseph R., Amber’s biological father. During the
    marriage, Mother gave birth to Ashley and Andrew, though no father was listed on either child’s birth
    certificate. However, Mother named Jeffrey P. as the biological father of both Ashley and Andrew. During
    this case, the trial court terminated both fathers’ parental rights to their respective children, and neither
    father appealed the termination. Therefore, the fathers are not parties to this proceeding.
    -2-
    On March 14, 2017, Mother underwent a psychological evaluation with Will Beyer,
    a licensed senior psychological examiner. The evaluation revealed that Mother was
    emotionally unstable and unable to make rational decisions concerning the well-being of
    the Children due to her intellectual disability and mood disorders. The evaluation further
    found that Mother frequently depended on others for her own basic needs. Based, in large
    part, on Mother’s evaluation, on April 4, 2017, DCS created the first of four permanency
    plans for the family. Mother and her attorney participated in the plan’s creation, and
    Mother signed it. The plan, which the trial court ratified on May 2, 2017, required Mother
    to: (1) provide a safe and stable home environment and provide for the Children’s basic
    needs; (2) apply at the Housing Authority in Benton and/or Carroll counties or other rental
    communities; (3) follow Mr. Beyer’s recommendations from the psychological evaluation;
    (4) complete mental health intake forms at local mental health facilities and follow
    recommendations; (5) participate in counseling and psychiatric services; (6) complete
    parenting and budgeting classes and follow recommendations (could be completed via in-
    home services); (7) participate in counseling, which includes education on social skills,
    interpersonal boundaries, and parenting; (8) avoid relationships that pose a risk to her well-
    being or that of the Children; and (9) complete anger management (could be completed via
    in-home services). Thereafter, the plan was amended three times, although the amended
    plans’ requirements for Mother are substantively the same as the responsibilities in the
    initial plan.4
    DCS provided Mother with services for well over one year, discussed infra, without
    Mother making much progress on the permanency plans. Importantly, Mother failed to
    establish a safe and stable home environment for the Children. Rather, Mother continued
    to drift between the homes of family, friends, and acquaintances in three different cities.
    Accordingly, on July 19, 2018, DCS filed a petition to terminate Mother’s parental rights
    on the grounds of: (1) abandonment by failure to provide a suitable home; (2) substantial
    noncompliance with permanency plan; (3) persistence of conditions; and (4) mental
    incompetence. DCS also alleged that termination of Mother’s parental rights was in the
    Children’s best interests.
    The trial court heard DCS’ petition on February 22, 2019, and the following
    witnesses testified: (1) Mr. Beyer, a licensed senior psychological examiner who conducted
    Mother’s psychological evaluations; (2) Courtney Affolter, Mother’s first DCS
    caseworker; (3) Kelly Fries, Mother’s final in-home services counselor; (4) Laura Tony,
    Amber’s counselor; (5) Mother; (6) Haley Kalinowski, Mother’s second DCS caseworker;
    (7) Desiree M., the Children’s foster mother at the time of trial; and (8) Ralph Z., Mother’s
    father. DCS entered thirty exhibits into evidence, including: (1) Mr. Beyer’s psychological
    evaluations of Mother; (2) documents from the underlying dependency and neglect case;
    4
    The trial court ratified each permanency plan. Additionally, it found that the goals of each plan
    were appropriate, that the responsibilities were reasonably related to achieving said goals, and that the goals
    were in the best interest of the Children.
    -3-
    and (3) all four permanency plans and the trial court’s orders ratifying same.
    By order of May 2, 2019, the trial court terminated Mother’s parental rights on the
    grounds of: (1) abandonment by failure to provide a suitable home; (2) substantial
    noncompliance with permanency plan; (3) persistence of conditions; and (4) mental
    incompetence. The trial court also found that termination of Mother’s parental rights was
    in the Children’s best interests. On May 24, 2019, Mother filed a motion to amend
    judgment and to stay execution of judgment, which the trial court denied on July 30, 2019.
    Mother appeals.
    II. Issues5
    We state the dispositive issues as follows:
    1. Whether there is clear and convincing evidence to support at least one of the
    grounds relied upon by the trial court to terminate Appellant’s parental rights.
    2. Whether termination of Appellant’s parental rights is in the Children’s best interests.
    III. Standard of Review
    The Tennessee Supreme Court has previously explained that:
    A parent’s right to the care and custody of her child is among the oldest of
    the judicially recognized fundamental liberty interests protected by the Due
    Process Clauses of the federal and state constitutions. Troxel v. Granville,
    
    530 U.S. 57
    , 65, 
    120 S. Ct. 2054
    , 
    147 L.Ed.2d 49
     (2000); Stanley v. Illinois,
    
    405 U.S. 645
    , 651, 
    92 S. Ct. 1208
    , 
    31 L.Ed.2d 551
     (1972); In re Angela E.,
    
    303 S.W.3d 240
    , 250 (Tenn. 2010); In re Adoption of Female Child, 
    896 S.W.2d 546
    , 547-48 (Tenn. 1995); Hawk v. Hawk, 
    855 S.W.2d 573
    , 578-79
    (Tenn. 1993). But parental rights, although fundamental and constitutionally
    protected, are not absolute. In re Angela E., 
    303 S.W.3d at 250
    . “‘[T]he
    [S]tate as parens patriae has a special duty to protect minors . . . .’ Tennessee
    5
    We note that DCS raised in its brief the issue of “[w]hether the Court should consider the post-
    judgment documents in the record.” The only facts this Court may consider on appeal are those “established
    by the evidence in the trial court and set forth in the record and any additional facts that may be judicially
    noticed or are considered pursuant to rule 14.” Tenn. R. App. P. 13(c). Tennessee Rule of Appellate
    Procedure 14 provides that a party may file a motion asking this Court to consider post-judgment facts. See
    Tenn. R. App. P. 14(a). Additionally, Rule 14 allows this Court the discretion to “consider facts concerning
    the action that occurred after judgment.” See Tenn. R. App. P. 14(a). Here, neither party filed a motion
    under Rule 14, and we decline to exercise our discretion in this case. Accordingly, we have limited our
    review of the record to the facts established as evidence in the trial court.
    -4-
    law, thus, upholds the [S]tate’s authority as parens patriae when interference
    with parenting is necessary to prevent serious harm to a child.” Hawk, 
    855 S.W.2d at 580
     (quoting In re Hamilton, 
    657 S.W.2d 425
    , 429 (Tenn. Ct.
    App. 1983)); see also Santosky v. Kramer, 
    455 U.S. 745
    , 747, 
    102 S.Ct. 1388
    , 
    71 L. Ed.2d 599
     (1982); In re Angela E., 
    303 S.W.3d at 250
    .
    In re Carrington H., 
    483 S.W.3d 507
    , 522-23 (Tenn. 2016) (footnote omitted). In
    Tennessee, termination of parental rights is governed by statute, which identifies
    “‘situations in which that state’s interest in the welfare of a child justifies interference with
    a parent’s constitutional rights by setting forth grounds on which termination proceedings
    can be brought.’” In re Jacobe M.J., 
    434 S.W.3d 565
    , 568 (Tenn. Ct. App. 2013) (quoting
    In re W.B., Nos. M2004-00999-COA-R3-PT, M2004-01572-COA-R3-PT, 
    2005 WL 1021618
    , at *7 (Tenn. Ct. App. Apr. 29, 2005) (citing 
    Tenn. Code Ann. § 36-1-113
    (g))).
    Thus, a party seeking to terminate a parent’s rights must prove: (1) the existence of one of
    the statutory grounds; and (2) that termination is in the child’s best interest. 
    Tenn. Code Ann. § 36-1-113
    (c); In re D.L.B., 
    118 S.W.3d 360
    , 367 (Tenn. 2003); In re Valentine, 
    79 S.W.3d 539
    , 546 (Tenn. 2002).
    Considering the fundamental nature of a parent’s rights and the serious
    consequences that stem from termination of those rights, a higher standard of proof is
    required in determining termination cases. Santosky, 
    455 U.S. at 769
    . As such, a party
    must prove statutory grounds and the child’s best interest by clear and convincing evidence.
    
    Tenn. Code Ann. § 36-1-113
    (c); In re Valentine, 
    79 S.W. 3d at 546
    . Clear and convincing
    evidence “establishes that the truth of the facts asserted is highly probable . . . and
    eliminates any serious or substantial doubt about the correctness of the conclusions drawn
    from evidence[,]” and “produces in a fact-finder’s mind a firm belief or conviction
    regarding the truth of the facts sought to be established.” In re M.J.B., 
    140 S.W.3d 643
    ,
    653 (Tenn. Ct. App. 2004).
    In termination of parental rights cases, appellate courts review a trial court’s factual
    findings de novo and accord these findings a presumption of correctness unless the
    evidence preponderates otherwise. Tenn. R. App. P. 13(d); In re Carrington H., 483
    S.W.3d at 523-24 (citing In re Bernard T., 
    319 S.W.3d 586
    , 596 (Tenn. 2010); In re
    M.L.P., 
    281 S.W.3d 387
    , 393 (Tenn. 2009); In re A.M.H., 
    215 S.W.3d 793
    , 809 (Tenn.
    2007)). The Tennessee Supreme Court has explained that:
    The trial court’s ruling that the evidence sufficiently supports termination of
    parental rights is a conclusion of law, which appellate courts review de novo
    with no presumption of correctness. In re M.L.P., 
    281 S.W.3d at 393
    (quoting In re [A.M.H.], 
    215 S.W.3d at 810
    ). Additionally, all other
    questions of law in parental termination appeals, as in other appeals, are
    reviewed de novo with no presumption of correctness. In re Angela E., 
    303 S.W.3d at 246
    .
    -5-
    In re Carrington H., 483 S.W.3d at 524. With the foregoing in mind, we turn to analyze
    the grounds under which the trial court terminated Mother’s parental rights.
    IV. Grounds for Termination
    A. Abandonment by Failure to Provide a Suitable Home
    The trial court found, by clear and convincing evidence, that Mother abandoned the
    Children when she failed to provide a suitable home. Tennessee Code Annotated section
    36-1-113(g)(1) authorizes termination of parental rights on the ground of abandonment as
    defined by Tennessee Code Annotated section 36-1-102(1)(A)(ii) when:
    (ii)(a) The child has been removed from the home or the physical or legal
    custody of a parent . . . by a court order at any stage of proceedings in which
    a petition has been filed in the juvenile court alleging that a child is a
    dependent and neglected child, and the child was placed in the custody of the
    department or a licensed child-placing agency;
    (b) The juvenile court found, or the court where the termination of parental
    rights petition is filed finds, that the department or a licensed child-placing
    agency made reasonable efforts to prevent removal of the child or that the
    circumstances of the child’s situation prevented reasonable efforts from
    being made prior to the child’s removal; and
    (c) For a period of four (4) months following the physical removal, the
    department or agency made reasonable efforts to assist the parent . . . to
    establish a suitable home for the child, but that the parent . . . ha[s] not made
    reciprocal reasonable efforts to provide a suitable home and ha[s]
    demonstrated a lack of concern for the child to such a degree that it appears
    unlikely that they will be able to provide a suitable home for the child at an
    early date. The efforts of the department or agency to assist a parent . . . in
    establishing a suitable home for the child shall be found to be reasonable if
    such efforts equal or exceed the efforts of the parent . . . toward the same
    goal, when the parent . . . is aware that the child is in the custody of the
    department;
    
    Tenn. Code Ann. § 36-1-102
     (1)(A)(ii). Concerning the first element, it is undisputed that
    the Children were removed from Mother’s care by court order on March 7, 2017.
    Concerning the second element, in its order terminating Mother’s parental rights, the trial
    court found that DCS made reasonable efforts to prevent the Children’s removal from
    Mother. See 
    Tenn. Code Ann. § 36-1-102
     (1)(A)(ii)(b). We agree. As discussed, supra,
    when DCS learned that Mother and the Children were homeless, DCS tried to help Mother
    -6-
    obtain housing, but she refused help. Despite Mother’s refusal, DCS still provided the
    family with groceries and hygiene products on multiple occasions. Accordingly, we agree
    that DCS made reasonable efforts to prevent removal of the Children from Mother’s care.
    
    Tenn. Code Ann. § 36-1-102
     (1)(A)(ii)(b).
    We now turn to the final element, whether DCS made reasonable efforts to assist
    Mother in establishing a suitable home for a period of four months following the Children’s
    removal, and whether Mother made reciprocal efforts to establish same. As an initial
    matter, we note that DCS’ efforts to assist a parent “shall be found to be reasonable if such
    efforts equal or exceed the efforts of the parent . . . toward the same goal . . . .” Tenn.
    Code. Ann. § 36-1-102(1)(A)(ii)(c). Additionally, “[a] suitable home ‘requires more than
    a proper physical living location.’” In re Navada N., 
    498 S.W.3d 579
    , 595 (Tenn. Ct. App.
    2016) (quoting In re Hannah H., No. E2013-01211-COA-R3-PT, 
    2014 WL 2587397
    , at
    *9 (Tenn. Ct. App. June 10, 2014)). It requires “[a]ppropriate care and attention . . . to the
    child[ren].” In re Matthew T., No. M2015-00486-COA-R3-PT, 
    2016 WL 1621076
    , at *7
    (Tenn. Ct. App. Apr. 20, 2016). Further, “a parent’s compliance with counseling
    requirements is ‘directly related to the establishment of a suitable home.’” 
    Id.
     (citing In
    re M.F.O., No. M2008-01322-COA-R3-PT, 
    2009 WL 1456319
    , at *5 (Tenn. Ct. App. May
    21, 2009)). Indeed, “the problems and conditions for which the various . . . counseling
    efforts were conducted address matters[,] which make the home environment suitable for
    raising children . . . .” In re M.F.O., 
    2009 WL 1456319
    , at *5. With this understanding,
    we turn to the record.
    On March 14, 2017, immediately following the Children’s removal, DCS arranged
    for Mother to participate in a psychological evaluation with Mr. Beyer, discussed infra, the
    purpose of which was to discern Mother’s mental health status “and her ability to provide
    an adequate, safe[,] and stable home environment for her [C]hildren.” On April 4, 2017,
    using Mother’s results from the evaluation, DCS worked with Mother to create the first
    permanency plan, which stated the permanency goal for the Children as “return to
    parent/placement with kin/relative.” The initial plan, discussed infra, provided that DCS
    would transport Mother to local housing authorities or other potential rental communities
    and would assist her with any fees associated with moving into a new home, such as
    deposits and utilities. The plan also outlined that, at Mr. Beyer’s recommendation, DCS
    would refer Mother to counseling and psychiatric services. Finally, the plan stated that
    DCS would also refer Mother to in-home service providers who would work with Mother
    to complete parenting classes and anger management.
    In its final order, the trial court found that DCS caseworkers: (1) “encouraged
    Mother to apply for public housing and explained the benefits available” to her; (2)
    “prepped [Mother] for her applications for rentals;” and (3) transported Mother to apply
    for non-public housing after Mother rejected public housing. The trial court also found
    that DCS provided Mother with in-home services “in an attempt to teach her to function in
    daily life.” Indeed, the record shows that DCS continually worked with Mother, during,
    -7-
    and beyond, the four-months following the Children’s removal.6 Throughout the pendency
    of this case, two DCS caseworkers supported Mother, Ms. Affolter (from March 2017
    through September 2018) and Ms. Kalinowski (from September 2018 through trial), both
    of whom testified at trial that they tried to help Mother obtain public and non-public
    housing. Despite DCS’ efforts, on appeal, Mother effectively argues that it was wrong for
    DCS to encourage Mother to apply for affordable public housing because “DCS knew it
    was going to be difficult for Mother to secure public housing because she could not locate
    a copy of her birth certificate, state identification, or [s]ocial [s]ecurity [c]ard.” However,
    Mother fails to recognize that DCS tried to help her procure these documents. Indeed, Ms.
    Affolter testified that she attempted to apply for a birth certificate on Mother’s behalf, but
    was not allowed. Thereafter, she reminded Mother on many occasions to look for her birth
    certificate or apply for a new one, but Mother would make excuses to not follow through.
    Similarly, Ms. Kalinowski testified that she scheduled three to four appointments with
    Mother to transport her to acquire a new social security card, but Mother cancelled for
    various reasons. The fact that Mother could not locate her birth certificate or social security
    card did not preclude her from applying for public housing. Rather, Mother’s own
    inactions, despite DCS’ efforts, prevented her from securing public housing.7
    In addition to trying to help Mother find stable housing, DCS also made efforts to
    help Mother establish a suitable home environment for the Children. In March 2017, DCS
    referred Mother to in-home counseling services, which she received through December
    6
    On appeal, Mother argues that the trial court “did not focus its attention on the relevant four-
    month period of time [from March 7, 2017 to July 7, 2017],” but rather “assessed the entirety of the case,
    finding that Mother moved multiple times since the [C]hildren were removed and finding that all services
    DCS offered to Mother since the removal relevant to the analysis.” Mother argues that such a “broad
    assessment is not proper for this ground.” As an initial matter, Mother fails to provide any law to support
    her argument. Further, we have explained that Tennessee Code Annotated section 36-1-102(1)(A)(ii) “does
    not limit the window during which DCS may satisfy its obligation to make reasonable efforts to the four-
    month period directly following statutory removal.” In re J.D.L., No. M2009-00574-COA-R3-PT, 
    2009 WL 4407786
    , at *12 n.8 (Tenn. Ct. App. Dec. 2, 2009) (citing In re J.C.W., No. M2007-02433-COA-R3-
    PT, 
    2008 WL 4414675
    , at *4-6 (Tenn. Ct. App. Sept. 26, 2008) (no perm. app. filed) (examining both the
    four-month period following removal and the four-month period preceding the filing of DCS’ termination
    petition)); see also In re Jakob O., No. M2016-00391-COA-R3-PT, 
    2016 WL 7243674
    , at *13 (Tenn. Ct.
    App. Dec. 15, 2016). Rather, DCS is required to make “‘reasonable efforts’ for a four-month period
    following the removal of the children.” In re Rahjada W., No. E2019-01798-COA-R3-PT, 
    2020 WL 2893434
    , at *5 (Tenn. Ct. App. June 3, 2020) (emphasis added); see also In re Brian W., No. M2020-
    00172-COA-R3-PT, 
    2020 WL 6390132
    , at *6 (Tenn. Ct. App. Oct. 30, 2020). Here, DCS made reasonable
    efforts to assist Mother well beyond the required four-month period, giving her more time to demonstrate
    that she could establish a suitable home. Accordingly, the trial court did not err when it considered the
    entirety of the case.
    7
    We note that, on appeal, Mother also blames DCS for her instability and homelessness, stating
    that “Mother had stable housing with her parents, but DCS insisted that she find her own home.” As
    discussed, infra, Mother’s relationship with her family is one of instability and volatility. The record
    demonstrates that Mother frequently moved in and out of her parents’ home, and Mother herself expressed
    that she did not want to live with her family due to the tumultuous relationship. Further, for reasons
    discussed, infra, Mother’s parents’ house was unsuitable for the Children.
    -8-
    2018. The goal of these services was to give Mother the tools to create a suitable home for
    the Children. Specifically, the providers addressed Mother’s issues related to parenting,
    budgeting, housing, cleanliness, coping skills, anger management skills, and appropriate
    relationships and boundaries. Unfortunately, the record demonstrates that Mother was
    inconsistent with her in-home counseling services, and she often cancelled appointments
    with providers. At trial, Ms. Fries, Mother’s final in-home counselor, testified that Mother
    failed to make progress because she cancelled so many appointments. As a result, Ms.
    Fries discontinued services with Mother in December 2018.
    Likewise, in May 2017, after Mother’s initial psychological evaluation, DCS
    referred her to Carey Counseling for mental health counseling, medication management,
    and other services. Mother began therapy in October 2017. Unfortunately, the record
    shows that Mother was inconsistent with her treatment. Mother’s caseworkers testified
    that they offered to drive Mother to her therapy appointments, but she often refused help.8
    As a result, she missed several of these appointments, because she either forgot about them
    or could not arrange for transportation. The record also shows that, because Mother
    frequently moved cities, she often changed mental health providers, which led to a lapse in
    her treatment. Indeed, Mother failed to attend counseling appointments and to take her
    prescription medications from March 2018 through June 2018.
    In light of the foregoing, the trial court found that DCS “made numerous reasonable
    efforts to assist Mother [in] provid[ing] a suitable home . . .” for the Children. Indeed, we
    agree that DCS provided Mother with comprehensive, holistic services to help her find
    adequate housing and to create a suitable home environment for the Children. Notably,
    Ms. Affolter testified that she did not believe there were any other services available that
    DCS could have provided to Mother.9 Nevertheless, despite all these services, it is clear
    from the record that Mother failed to make reciprocal efforts toward procuring a safe and
    stable environment to which the Children could return. The trial court found, by clear and
    convincing evidence, that,
    during the two-year period[] that Mother has not had [t]he Children[,] she
    has not established a suitable home which would be safe and stable for the
    Children. She has made very little effort to do so. The efforts of [DCS] far
    exceed any reasonable efforts by Mother, and, based upon the actions of
    Mother, she has abandoned her rights to the Children. It is very unlikely that
    Mother will be able to provide a suitable home for the Children at an early
    date, if ever.
    8
    Mother does not drive and has never had a driver’s license.
    9
    Despite all the services mentioned above, Mother argues on appeal that DCS failed to provide her
    with targeted mental health treatment to address her intellectual disability and mood disorders. However,
    the record reflects that, prior to trial, Mother believed the services she received were helping her.
    -9-
    We agree. “‘Parents desiring the return of their children must . . . make reasonable
    and appropriate efforts to rehabilitate themselves and to remedy the conditions that
    required the Department to remove their children from custody.’” In re Kambri P., No.
    M2019-01352-COA-R3-PT, 
    2020 WL 2991793
    , at *5 (Tenn. Ct. App. June 4, 2020)
    (quoting In re Shameel S., No. E2014-00294-COA-R3-PT, 
    2014 WL 4667571
    , at *5
    (Tenn. Ct. App. Sept. 19, 2014)). We conclude that Mother failed to make such reasonable
    and appropriate efforts, and that DCS’ efforts to assist her in establishing a suitable home
    exceeded Mother’s own efforts to accomplish the same. 
    Tenn. Code Ann. § 36-1-102
    (1)(A)(ii)(c). Though DCS provided Mother with services to address her homelessness,
    mental health issues, issues with cleanliness, and trouble managing money, the record
    shows that Mother either refused these services or did not use them consistently. See In re
    M.F.O., 
    2009 WL 1456319
    , at *5 (“The failure of [m]other and [f]ather to cooperate with
    DCS and to comply with the requirements of the various counseling services was directly
    related to the establishment and maintenance of a suitable home.”). Mother’s limited
    efforts to find suitable housing and her failure to consistently comply with her mental
    health treatment and in-home counseling services, demonstrates her lack of concern for the
    Children and her inability to provide a suitable home environment. 
    Tenn. Code Ann. § 36
    -
    1-102 (1)(A)(ii)(c); see In re Roderick R., No. E2017-01504-COA-R3-PT, 
    2018 WL 1748000
    , at *12 (Tenn. Ct. App. Apr. 11, 2018) perm. app. denied (Tenn. July 12, 2018)
    (“Mother’s own failure to comply with her mental health treatment regimen demonstrated
    her lack of concern for the [c]hildren and resulted in her inability to provide a suitable
    home environment.”). Given the foregoing, we agree with the trial court that it appears
    unlikely that Mother will be able to provide a suitable home for the Children at an early
    date, if ever. 
    Tenn. Code Ann. § 36-1-102
     (1)(A)(ii)(c). Accordingly, we affirm the trial
    court’s finding, by clear and convincing evidence, that Mother abandoned the Children by
    failure to provide a suitable home.
    B. Substantial Noncompliance with Permanency Plan
    The trial court also found, by clear and convincing evidence, that Mother’s parental
    rights should be terminated on the ground of substantial noncompliance with the
    requirements of the permanency plans. Tennessee Code Annotated section 36-1-113(g)(2)
    provides that a parent’s rights may be terminated when “[t]here has been substantial
    noncompliance by the parent . . . with the statement of responsibilities in a permanency
    plan . . . .” 
    Tenn. Code Ann. § 36-1-113
    (g)(2). When addressing this ground, “[o]ur
    concern is with the parent’s efforts to comply with the plan, not the achievement of the
    plan’s desired outcomes.” In re Daniel B., Jr., No. E2019-01063-COA-R3-PT, 
    2020 WL 3955703
    , at *5 (Tenn. Ct. App. July 10, 2020).
    As discussed by this Court in In re A.J.R., No. E2006-01140-COA-R3-PT, 
    2006 WL 3421284
    , at *4 (Tenn. Ct. App. Nov. 28, 2006):
    - 10 -
    To prevail in a termination case on a claim of substantial noncompliance with
    a permanency plan, DCS must prove: (1) the terms of the plan, Dep’t of
    Children’s Services v. D.W.J., No. E2004-02586-COA-R3-PT, 
    2005 WL 1528367
     (Tenn. Ct. App. E.S., June 29, 2005); (2) that the plan requirements
    were reasonable and related to remedying the conditions that caused the child
    to be removed from the parent’s custody in the first place, In re
    Valentine, 
    79 S.W.3d at 547
    ; In re L.J.C., 
    124 S.W.3d 609
    , 621 (Tenn. Ct.
    App. 2003); and (3) that the parent’s noncompliance was substantial in light
    of the degree of noncompliance and the importance of the particular
    requirement that has not been met. Valentine, 
    79 S.W.3d at 548-49
    ; In re
    Z.J.S., No. M2002-02235-COA-R3-JV, 
    2003 WL 21266854
    , at *12 (Tenn.
    Ct.App. M.S., June 3, 2003); Dep’t of Children’s Services v. T.M.B.K., 
    197 S.W.3d 282
    , 293 (Tenn. Ct. App. 2006).
    In re A.J.R., 
    2006 WL 3421284
    , at *4.
    In its order terminating Mother’s parental rights, the trial court found that
    . . . although there were many actions required to be taken, the basic goals
    for the Children to return home were that Mother provide a safe, stable home
    provided with utilities and food necessary for a reasonable life, free of
    negative influences such as drugs.10
    ***
    The majority of Mother’s responsibilities, in addition to obtaining safe and
    stable housing for her and the Children, required Mother to obtain mental
    counseling and anger management. Mother was given certain dates to
    complete her statement of responsibilities. Mother was either unwilling or
    unable to complete the responsibilities required of her to regain custody of
    the Children.
    The trial court’s order concerning Mother’s substantial noncompliance with the
    permanency plans is deficient. As an initial matter, the trial court failed to find that the
    requirements of the plans were “reasonable and related to remedying the conditions which
    necessitate[d] foster care placement.” 
    Tenn. Code Ann. § 37-2-403
    (a)(2)(C). The
    Tennessee Supreme Court has held “that this finding must be made in conjunction with the
    determination of substantial noncompliance under § 36-1-113(g)(2).” In re Valentine, 
    79 S.W.3d at 547
    . Because the trial court failed to make findings concerning the
    10
    We note that, under the section of its order titled “Substantial noncompliance with permanency
    plan,” the trial court curiously began making findings concerning the persistence of conditions ground,
    discussed infra. We omit that portion of the trial court’s order here.
    - 11 -
    reasonableness of Mother’s responsibilities under the permanency plans, we review this
    issue de novo. 
    Id.
    “Conditions necessitating foster care placement may include conditions related both
    to the child[ren]’s removal and to family reunification.” 
    Id.
     As stated in the initial
    permanency plan, the Children were removed from Mother’s custody due to environmental
    neglect stemming from Mother’s instability and inability to provide for the Children’s basic
    needs. Specifically, as discussed, supra, in January 2017, Mother and her then-boyfriend
    reported to the police that the couple, along with the Children, were homeless. Prior to
    becoming homeless, it was reported that Mother, her boyfriend, and the Children lived with
    strangers, family, or in hotels. Soon after the Children entered DCS custody, it became
    apparent that Mother’s mental health struggles hindered her ability to establish safe and
    stable interpersonal relationships, to keep a clean house, and to budget her money, all of
    which also prevented Mother from regaining custody of the Children. As discussed supra,
    Mother’s requirements under the permanency plans were to: (1) provide a safe and stable
    home environment and provide for the Children’s basic needs; (2) apply at the Housing
    Authority in Benton and/or Carroll counties or other rental communities; (3) follow Mr.
    Beyer’s recommendations from the psychological evaluation; (4) complete mental health
    intake forms at local mental health facilities and follow recommendations; (5) participate
    in counseling and psychiatric services; (6) complete parenting and budgeting classes and
    follow recommendations (could be completed via in-home services); (7) participate in
    counseling, which includes education on social skills, interpersonal boundaries, and
    parenting; (8) avoid relationships that pose a risk to her well-being or that of the Children;
    and (9) complete anger management (could be completed via in-home services).
    Considering Mother’s issues with homelessness, her mental health struggles, and her
    failure to provide the Children with a suitable home environment, we conclude that the
    above requirements were reasonable and related to remedying the conditions that
    necessitated foster care placement in this case. 
    Tenn. Code Ann. § 37-2-403
    (a)(2)(C).
    Accordingly, we turn to the question of whether Mother was substantially noncompliant
    with her responsibilities under the permanency plans.
    Regrettably, the trial court’s order concerning Mother’s substantial noncompliance
    provides no specific factual findings and only generally states that “Mother was either
    unwilling or unable to complete the responsibilities required of her to regain custody of the
    Children.” However, when considering the trial court’s entire order, and upon our de novo
    review of the record, we conclude that Mother was substantially noncompliant with her
    responsibilities under the permanency plans.
    The Tennessee Supreme Court has explained that
    [s]ubstantial noncompliance is not defined in the termination statute. The
    statute is clear, however, that noncompliance is not enough to justify
    termination of parental rights; the noncompliance must be substantial.
    - 12 -
    Black’s Law Dictionary defines “substantial” as “[o]f real worth and
    importance.” Black’s Law Dictionary 1428 (6th ed. 1990). In the context of
    the requirements of a permanency plan, the real worth and importance of
    noncompliance should be measured by both the degree of noncompliance
    and the weight assigned to that requirement.
    In re Valentine, 
    79 S.W.3d at 548
    . We acknowledge that Mother completed some of the
    permanency plan requirements. She participated in Mr. Beyer’s evaluations and in some
    mental health counseling, she sporadically engaged the services of her in-home counselors,
    she briefly obtained independent housing, and she attended parenting classes. Clearly,
    Mother made some effort.
    However, as we have explained before, “permanency plans are not simply a series
    of hoops for the biological parent to jump through in order to have custody of the children
    returned.” In re C.S., Jr., et al., No. M2005-02499-COA-R3-PT, 
    2006 WL 2644371
    , at
    *10 (Tenn. Ct. App. Sept. 14, 2006). Rather,
    the requirements of the permanency plan are intended to address the
    problems that led to removal; they are meant to place the parent in a position
    to provide the children with a safe, stable home and consistent appropriate
    care. This requires the parent to put in real effort to complete the
    requirements of the plan in a meaningful way in order to place herself in a
    position to take responsibility for the children.
    
    Id.
     As discussed, supra, the record demonstrates that Mother failed to put forth a real effort
    to complete her responsibilities under the permanency plans in a meaningful way. Id.
    Arguably, Mother’s two most important responsibilities under the plans were to obtain safe
    and stable housing and to consistently participate in her mental health treatment.
    Complying with these responsibilities may have likely placed Mother in the position to
    provide the Children “with a safe, stable home and consistent appropriate care.” Id.
    Unfortunately, Mother was substantially noncompliant with both. Though she had
    assistance from DCS, Mother failed to follow through with applying for public housing.
    While Mother obtained non-public housing, the record shows that she did not remain in
    these homes for long. During the pendency of this case, Mother bounced between her
    friends’ and families’ houses, never obtaining safe, stable housing for an extended period
    of time. At the time of trial, Mother was still without same. Additionally, while Mother
    occasionally participated in mental health counseling, she often cancelled or failed to show
    up to her appointments, and the record shows that Mother went months without mental
    health treatment and medications. Similarly, though Mother sporadically participated in
    in-home counseling services, as discussed, supra, Ms. Fries discontinued services with
    Mother because Mother cancelled so many appointments that she failed to make any real
    progress. Finally, also of great concern, the record shows that, discussed, infra, Mother
    continued to seek relationships with men who posed a risk to her well-being and to that of
    - 13 -
    the Children.
    “Determining whether a parent has substantially complied with a permanency plan
    involves more than merely counting up the tasks in the plan to determine whether a certain
    number have been completed and ‘going through the motions’ does not constitute
    substantial compliance.” In re Carrington H., 483 S.W.3d at 537. Here, it appears Mother
    was simply “going through the motions.” “Mother could have used this opportunity to
    address her most serious problems. . . .” In re C.S., Jr., et al., 
    2006 WL 2644371
    , at *10.
    She could have used DCS as a resource to help her obtain safe and stable, affordable
    housing. She could have consistently participated in her mental health treatment and in-
    home counseling services to help her make healthy decisions, to learn how to manage her
    daily life, and to provide a suitable home environment for the Children. Instead, Mother
    made inconsistent, superficial efforts that “fell far short of reaching the overall goal of the
    permanency plans, which was for Mother to demonstrate that she had changed her
    conditions so that she could take full responsibility for raising her [three] children in a
    healthy, safe, stable home.” 
    Id.
     Accordingly, we conclude that the evidence clearly and
    convincingly supports the trial court’s finding and conclusion that Mother was
    substantially noncompliant with the permanency plans.
    C. Persistence of Conditions
    The trial court also found that termination of Mother’s parental rights was
    appropriate under Tennessee Code Annotated section 36-1-113(g)(3), a ground commonly
    referred to as “persistence of conditions.” In re Audrey S., 
    182 S.W.3d 838
    , 871 (Tenn.
    Ct. App. 2005). The persistence of conditions ground focuses “on the results of the parent’s
    efforts at improvement rather than the mere fact that he or she had made them.” 
    Id. at 874
    (emphasis added). The goal is to avoid having a child in foster care for a time longer than
    reasonable for the parent to demonstrate the ability to provide a safe and caring
    environment for the child. See In re A.R., No. W2008-00558-COA-R3-PT, 
    2008 WL 4613576
    , at *20 (Tenn. Ct. App. Oct. 13, 2008) (quoting In re D.C.C., No. M2007-01094-
    COA-R3-PT, 
    2008 WL 588535
    , at *9 (Tenn. Ct. App. Mar. 3, 2008) (“The purpose behind
    the [persistence of conditions] ground is to prevent the child’s lingering in the uncertain
    status of foster child if a parent cannot within a reasonable time demonstrate an ability to
    provide a safe and caring environment for the child.”)). Thus, the question before the court
    is whether it is likely “that the child can be safely returned to the custody of the [parent],
    not whether the child can safely remain in foster care with weekly visits with the [parent].”
    In re K.A.H., No. M1999-02079-COA-R3-CV, 
    2000 WL 1006959
    , at *5 (Tenn. Ct. App.
    July 21, 2000).
    There are several elements to the ground of persistence of conditions that must be
    shown to terminate parental rights, to-wit:
    The child has been removed from the home or the physical or legal custody
    - 14 -
    of a parent or guardian for a period of six (6) months by a court order entered
    at any stage of proceedings in which a petition has been filed in the juvenile
    court alleging that a child is a dependent and neglected child,11 and:
    (i) The conditions that led to the child’s removal still persist, preventing
    the child’s safe return to the care of the parent or guardian, or other
    conditions exist that, in all reasonable probability, would cause the
    child to be subjected to further abuse or neglect, preventing the child’s
    safe return to the care of the parent or guardian;
    (ii) There is little likelihood that these conditions will be remedied at
    an early date so that the child can be safely returned to the parent or
    guardian in the near future; and
    (iii) The continuation of the parent or guardian and child relationship
    greatly diminishes the child’s chances of early integration into a safe,
    stable, and permanent home;
    
    Tenn. Code Ann. § 36-1-113
    (g)(3)(A). Each of the statutory elements must be established
    by clear and convincing evidence. In re Valentine, 
    79 S.W.3d at 550
    . As noted above,
    the Children were removed from Mother’s custody on March 7, 2017, and the trial court
    heard the petition for termination on February 22, 2019, over twenty-one months after the
    Children’s removal.
    Before analyzing the remaining elements, we find it pertinent to first address
    Mother’s arguments concerning this ground on appeal. Mother does not appear to dispute
    that the conditions, which led to the Children’s removal persist. Rather, she argues that
    “[t]he main reason this ground should be dismissed is due to DCS’ contribution to Mother’s
    persistent conditions.” Specifically, Mother argues that DCS required her to “undergo a
    task beyond her ability—i.e. living alone.” Mother further argues that DCS “facilitated
    [her] ongoing instability by [not] allow[ing] her to remain with her parents” and by failing
    to “offer family services to remedy any conflict in [Mother’s] family.” However, the record
    shows that DCS did not require Mother to live alone or without support. Rather, as
    evidenced by the December 14, 2017 permanency plan, Mother’s providers were tasked
    with working with her to identify and develop positive support persons who could help
    care for the Children. Mother’s caseworkers likewise testified that DCS did not require
    Mother to live alone; instead, they encouraged her to find appropriate support. However,
    DCS informed Mother that her parents’ home environment and history with Child
    Protective Services prevented the Children’s placement there.
    11
    “The six (6) months must accrue on or before the first date the termination of parental rights
    petition is set to be heard.” 
    Tenn. Code Ann. § 36-1-113
    (g)(3)(B).
    - 15 -
    Indeed, the record shows that Mother’s parents’ home would not have been suitable
    for the Children. Mother’s parents’ house contained only two-bedrooms: Mother’s parents
    occupied one room, and the other room was described as “similar to a storage room.”
    Mother testified that she slept in either a recliner or on a “bed cot” when she stayed with
    her parents. There was hardly room for Mother and her parents in the house, let alone three
    children. Furthermore, Ms. Affolter testified that Mother’s family was very resistant to
    working with DCS, and they refused to allow DCS providers in their home. Accordingly,
    DCS did not find Mother’s parents’ house to be an appropriate home for the Children. We
    also note, while Mother’s father testified at trial that Mother and the Children could stay at
    his house, at the time of trial, several other people were living in the home, as well as
    fourteen dogs. This further supports that the home would not have been a suitable
    placement for the Children.
    Finally, we note that Mother’s relationship with her family is one of instability and
    volatility. While Mother moved in with her parents frequently, she left their home just as
    often. Mother herself reported to her caseworkers that she did not want to live with her
    family because of the tumultuous relationship. While Mother argues on appeal that DCS
    should have offered Mother and her family services to remedy this conflict, it is important
    to recognize that “proof of [DCS’] reasonable efforts is not a precondition to termination
    of parental rights.” In re Kambri P., 
    2020 WL 2991793
    , at *10 (citing In re Kaliyah S.,
    
    455 S.W.3d 533
    , 554 (Tenn. 2015)). Accordingly, DCS’ omission in providing Mother
    and her family counseling services has no bearing on whether DCS met its burden as to
    Mother’s persistence of conditions. Having addressed Mother’s arguments, we turn to the
    remaining elements of this ground.
    In its order, the trial court found that: (1) the Children had been removed from
    Mother’s custody for more than six months; (2) “[t]he conditions that led to the removal
    still persist, preventing the Children’s safe return to [Mother];” (3) “[t]here is little
    likelihood that these conditions will be remedied at an early date so that the Children can
    be safely returned to Mother;” and (4) “[t]he continuation of the parent and child
    relationship greatly diminishes the [Children’s] chances of early integration into a safe,
    stable, and permanent home.” The trial court further found that
    [a]ll three [C]hildren are in [a] foster home[] and living safe and stable lives.
    Although the [C]hildren love their mother, they do not want to return to her
    care. One of the Children now does not wish to visit [] Mother or talk on the
    telephone [with Mother]. [Mr.] Beyer also opined “after almost a year of
    supportive services she does not at this point appear to have established
    independent living nor does she appear to be capable of mature and rational
    decision-making required to provide for the day-to-day care of her children
    she still does not have a residence, furnishings, adequate income or a support
    system other than DCS upon which she can rely. She is not managing her
    limited income well. She continues to change residences frequently.”
    - 16 -
    The record supports these findings. As discussed, supra, the Children were removed
    from Mother’s care due to environmental neglect stemming from Mother’s instability and
    inability to provide for the Children’s basic needs. While DCS’ initial concern was
    Mother’s lack of housing, shortly after the Children entered DCS custody, it became clear
    that Mother’s mental health issues, discussed infra, also prevented her from establishing a
    suitable home environment for the Children. Notably, Mother struggled to understand how
    to: (1) establish safe and stable interpersonal relationships; (2) keep a clean house; and (3)
    budget her money.
    Turning to the record, as discussed, supra, it is clear that Mother’s housing remains
    unstable. Since the Children entered DCS custody in 2017, Mother has moved over ten
    times, rarely staying in one location for an extended period of time. While DCS attempted
    to help Mother secure affordable public housing, Mother insisted on finding other living
    arrangements on her own, resulting in her frequent moves. At trial, Mother testified that
    she currently resides in a two-bedroom trailer owned by David H. and located on Mr. H.’s
    father’s land. Concerningly, Mother met Mr. H. in August 2018 when he saw Mother
    walking in town, asked if she needed a ride, and she accepted. Without knowing Mr. H.
    for more than one month, Mother moved into his trailer at the end of August 2018. At trial,
    Mother insisted that Mr. H. was simply a “really, really close friend,” not a boyfriend.
    However, Mother later admitted that she miscarried Mr. H.’s child in November 2018.
    Mother’s immediate trust and reliance on Mr. H. demonstrates her dangerous pattern
    of engaging in romantic relationships with men she barely knows and relying on them for
    support. At trial, Mother acknowledged that she has chosen men in the past who were
    inappropriate for her Children to be around.12 Ms. Affolter testified that she cautioned
    Mother regarding the people with whom she associates, particularly the men with which
    she develops relationships. Ms. Affolter stressed to Mother that the people in Mother’s
    life, not only affect Mother’s safety, but the safety of her Children and their ability to return
    to her. Despite these conversations, Mother has continued to pursue relationships with men
    she does not know and has relied on them for support, as exemplified by her reliance on
    Mr. H. for her current home. Mother’s actions clearly demonstrate that she remains unable
    to choose appropriate sources of support not only for herself, but for the Children as well.
    12
    For example, Mother testified that, soon after the Children were taken into DCS custody, she met
    John S. who moved in with her one month later. Mother testified that Mr. S. lived with Mother for one
    month, but she forced him to leave after he threatened her with a knife. One or two months later, Mother
    was told that Mr. S. was accused of touching her niece in a sexually inappropriate manner, though Mother
    seemed to doubt the truthfulness of this accusation in her testimony. The evidence also demonstrates that,
    after Mother and Mr. S. broke up, Mother met a man named Damien/James (according to the record, this
    man goes by both “Damien” and “James.”). After Mother disclosed her relationship with this man to Ms.
    Affolter, Ms. Affolter informed Mother that he was on the sex offender registry. When Mother learned of
    this, she told Ms. Affolter that Damien/James was not her boyfriend, just her friend, and Mother continued
    to lean on him for support.
    - 17 -
    The record also shows that Mother continues to struggle with establishing a suitable
    environment for the Children. The cleanliness of Mother’s home has been a persistent
    issue throughout this case. When she began working with Mother, Ms. Affolter identified
    Mother’s pets as the cause of Mother’s uncleanliness. At trial, Ms. Affolter testified that
    Mother’s pets used the bathroom inside the house, and Mother failed to clean it up
    appropriately. As a result, Ms. Affolter had multiple conversations with Mother about the
    importance of cleanliness, especially when little children would be in the home.
    Nevertheless, this issue has persisted. At the time of trial, Mother had three dogs and one
    outside cat living with her. Both Ms. Kalinowski and Ms. Fries, who provided Mother
    services after Ms. Affolter, testified that the cleanliness of Mother’s home had not
    improved. Specifically, Ms. Kalinowski testified that, when she visited Mother’s home in
    December 2018, the home smelled strongly of urine, and she believed she sat in urine on
    the couch during her visit.
    In addition to her inability to provide a clean home, Mother also remains unable to
    budget her money. The record shows that Mother’s providers consistently worked with
    Mother concerning this issue. Nevertheless, at trial, Ms. Affolter testified that Mother
    frequently ran out of money by the second or third week of the month. Mother’s trial
    testimony confirmed that this issue persists. Mother testified that she is on a limited income
    of $810 per month from social security and food stamps. Her monthly expenses for
    electricity and food (she does not pay rent) total around $350. Notwithstanding a surplus
    of about $460 each month, at the time of trial, on February 22, 2019, Mother had no money
    in savings, and she had run out of money until her next check on March 1, 2019.
    There is clear and convincing evidence that the conditions, which led to the
    Children’s removal persist. 
    Tenn. Code Ann. § 36-1-113
    (g)(3)(A)(i). Additionally, it is
    unlikely that Mother’s instability and inability to provide for herself or the Children will
    be remedied at an early date so the Children could be returned to Mother in the near future.
    
    Tenn. Code Ann. § 36-1-113
    (g)(3)(A)(ii). At the time of trial, Mother had been working
    with DCS and service providers for nearly two years to remedy the conditions that led to
    the Children’s removal. Nevertheless, Mother continues to: (1) lack stable and appropriate
    housing; (2) choose unsafe and inappropriate relationships with men; (3) live in an unclean
    environment; and (4) mismanage her monthly income. “Where, as here, efforts to provide
    help to improve the parenting abilities, offered over a long period of time, have proved
    ineffective, the conclusion that there is little likelihood of such improvement as would
    allow the safe return of the child to the parent in the near future is justified.” In re A.R.,
    
    2008 WL 4613576
    , at *20 (citing In re T.S., No. M1999-01286-COA-R3-CV, 
    2000 WL 964775
    , at *7 (Tenn. Ct. App. July 13, 2000)). While it is possible that Mother’s
    intellectual disability or mental disorders, discussed infra, may prevent her from providing
    an appropriate environment for the Children, it does not excuse her. Indeed, we have
    explained before that “[a] parent’s continued inability to provide fundamental care to a
    child, even if not willful, whether caused by a mental illness, mental impairment, or some
    - 18 -
    other cause, constitutes a condition which prevents the safe return of the child to the
    parent’s care.” In re A.R., 
    2008 WL 4613576
    , at *20 (citing In re T.S., 
    2000 WL 964775
    ,
    at *7). Finally, there is no guarantee that Mother will ever be able to provide a safe and
    stable environment for the Children, “and the time spent waiting for this to occur greatly
    diminishes [the Children’s] chances of early integration into a safe, stable and permanent
    home.” In re A.R., 
    2008 WL 4613576
    , at *20 (citing In re T.S., 
    2000 WL 964775
    , at *7);
    see also 
    Tenn. Code Ann. § 36-1-113
    (g)(3)(A)(iii); In re D.C.C., 
    2008 WL 588535
    , at *9.
    Accordingly, we conclude that there is clear and convincing evidence that DCS met its
    burden as to the persistence of conditions ground.
    D. Mentally Incompetent to Provide Care and Supervision of the Children
    Lastly, the trial court found, by clear and convincing evidence, that Mother does not
    possess the mental competence required to properly care for the Children. Tennessee Code
    Annotated section 36-1-113(g)(8) provides:
    (8)(A) . . . [J]uvenile courts shall have jurisdiction . . . to determine if the
    parent or guardian is mentally incompetent to provide for the further care and
    supervision of the child, and to terminate that parent’s or guardian’s rights to
    the child;
    (B) The court may terminate the parental or guardianship rights of that person
    if it determines on the basis of clear and convincing evidence that:
    (i) The parent or guardian of the child is incompetent to adequately
    provide for the further care and supervision of the child because the
    parent’s or guardian’s mental condition is presently so impaired and is
    so likely to remain so that it is unlikely that the parent or guardian will
    be able to assume or resume the care of and responsibility for the child
    in the near future; and
    (ii) That termination of parental or guardian rights is in the best interest
    of the child.
    (C) In the circumstances described under subdivisions (8)(A) and (B), no
    willfulness in the failure of the parent or guardian to establish the parent’s or
    guardian’s ability to care for the child need be shown to establish that the
    parental or guardianship rights should be terminated;
    
    Tenn. Code Ann. § 36-1-113
    (g)(8). “For this ground, it is insufficient to show only that a
    parent suffers from mental incompetence; rather, ‘the real issue is whether this impairment
    adversely affects [the] ability to parent[.]’” In re Katrina S., No. E2019-02015-COA-R3-
    PT, 
    2020 WL 5269236
    , at *10 (Tenn. Ct. App. Sept. 3, 2020) (quoting In re C.C., No.
    - 19 -
    E2016-00475-COA-R3-PT, 
    2016 WL 5266669
    , at *13 (Tenn. Ct. App. Sept. 22,
    2016)); see also In re Quadayvon H., No. E2016-00445-COA-R3-PT, 
    2016 WL 7340427
    ,
    at *8 (Tenn. Ct. App. Sept. 30, 2016) (“The issue in this case is not whether Father has
    impaired cognitive functioning. Rather, the issue is whether his impairment adversely
    affects his ability to parent his children.”).
    In its order, the trial court found:
    Mother is mentally incompetent to provide for the future care and
    supervision of the Children. The evidence shows, by clear and convincing
    evidence, that [M]other is incompetent to adequately provide for the care and
    supervision of the Children because her mental condition is presently so
    impaired and so likely to remain so that [it] is unlikely that [Mother] will be
    able to assume or [resume] . . . the care of and responsibility [for] the
    Children in the near future.
    The psychological evaluation performed on Mother by Will Beyer . .
    . and the updated evaluation . . . indicate that Mother suffers from severe
    depressive disorder and weak verbal abilities. Mother is very low
    functioning and has difficulty making decisions with the Children. Will
    Beyer reached the same conclusions from both tests, 12 months apart.
    During the 12 months between the two evaluations, Mother moved seven
    times. It is the opinion of Will Beyer that, after almost a year of supportive
    services she does not at this point appear to be capable of mature and rational
    decision-making required to provide for the day-to-day care of her children.
    She still does not have a residence, furnishings, adequate income or a support
    system other than DCS upon which she can rely. She is not managing her
    limited income well. She continues to change residences frequently.
    Based upon the totality of the circumstances and the facts found as
    true and correct by the [c]ourt, unfortunately, Mother cannot provide a stable
    home or a stable environment for her Children and may never be able to do
    so. . . .
    As the trial court found, it based its conclusion concerning Mother’s mental
    incompetence on the testimony and reports of DCS’ witness, Mr. Beyer, a licensed senior
    psychological examiner and a licensed professional counselor. Mr. Beyer conducted the
    first psychological evaluation of Mother on March 14, 2017 and a follow-up evaluation on
    March 14, 2018. Based on diagnostic testing and two interviews with Mother, Mr. Beyer
    diagnosed her with borderline intellectual functioning, disruptive mood dysregulation
    disorder, adjustment disorder, and major depression. Concerning Mother’s intellectual
    disability, Mr. Beyer testified that her verbal comprehension test scores of 63 (from the
    - 20 -
    initial evaluation) and 68 (from the follow-up) were concerning.13 He explained that
    Mother’s scores placed her in the bottom 1-2% of individuals regarding verbal
    comprehension skills. Verbal comprehension affects a person’s general mental abilities
    and their academic learning abilities, as well as their ability to problem solve, use good
    judgment, and learn from their experiences. Importantly, Mr. Beyer testified that Mother’s
    intellectual disability could affect her ability to care for the Children because individuals
    within Mother’s range of scores often have difficulty providing for their day-to-day needs,
    are unable to make decisions (including financial decisions), have difficulty obtaining and
    maintaining employment, have difficulty maintaining a budget, and may have difficulty
    following directions. As a result, they often “require a lot of support from other
    individuals.” Mr. Beyer also testified that people with lower verbal comprehension scores
    are often manipulated by others resulting in trust issues, which can create conflict in
    relationships and impede an individual’s ability to identify appropriate relationships.
    Mother’s intellectual disability also causes her to misperceive information as she is
    unable to process or understand it. Unfortunately, when compounded with Mother’s mood
    disorders, such misperception often causes Mother to become reactive, upset, and angry.
    Ms. Affolter testified that Mother could be very impulsive and would react very quickly
    and angrily to certain situations. When Ms. Affolter would try to explain to Mother that
    Mother misunderstood some issue, Mother was often uninterested in an explanation
    because she was too upset by the situation. Ms. Affolter’s testimony is substantiated by
    Ms. Fries’ testimony that Mother became angry and resentful after Ms. Fries discussed the
    urine smell in Mother’s house and the need to clean same. Ms. Fries explained that Mother
    felt that Ms. Fries had bullied or picked on Mother, and Mother’s “focus would shift from
    prioritizing what [she] need[ed] to do to get [the Children] back to ‘someone’s being mean
    to me, and I’m going to express that.’”
    Such explosive and reactive behavior is indicative of a person who suffers from
    disruptive mood dysregulation disorder. According to Mr. Beyer, “a disruptive mood is .
    . . [when] an event occurs and a person over responds emotionally.” A person with
    disruptive mood dysregulation disorder may have difficulty regulating their moods based
    upon situational and contextual events. “They [might] get too excited, too angry, or . . .
    frustrated based upon those events.” Said behavior is also indicative of someone who
    suffers from an adjustment disorder. Due to this disorder, Mother “may have difficulty
    coping with stressors and things that [are] occurring in her life.” Mother exhibited
    behaviors related to both her disruptive mood dysregulation disorder and her adjustment
    disorder at her initial evaluation with Mr. Beyer. Mr. Beyer testified that Mother was very
    angry when she arrived at her appointment because the person who took her to the
    appointment left. Mr. Beyer wrote in his evaluation that, “[d]uring the course of the
    interview [Mother] became agitated, broke a pen, was cursing, became angry and then
    13
    Though there is a five-point difference between the scores, Mr. Beyer testified this deviation was
    normal.
    - 21 -
    became tearful and despondent.” Mr. Beyer called Ms. Affolter for assistance in calming
    Mother down, and both Mr. Beyer and Ms. Affolter explained to Mother the importance of
    participating in the evaluation. Despite these discussions, Mother remained focused on the
    trivial event of her ride leaving her, and she failed to comprehend the significance of the
    evaluation and the effect it would have on her ability to resume custody of the Children.
    In the initial evaluation, Mr. Beyer also noted that Mother was emotionally unstable
    despite her denial “of serious symptoms of mood disturbance on various assessment
    instruments.” Mr. Beyer’s personality testing found that Mother suffered from “serious
    levels” of major depression. Accordingly, he diagnosed her with major depression because
    he observed that she had “[d]aily feelings of dejection, apathy, and pessimism.” He also
    reported that Mother was preoccupied with self-doubts, that she had a recurrent pattern of
    thoughts of death, and periodic thoughts of suicide.
    It is unclear whether Mother understands the extent of her intellectual disability or
    mood disorders. As an initial matter, Mother is unable to explain why she receives social
    security disability, believing she receives it because she “can’t be around a lot of people,
    [be]cause [she doesn’t] get along with a lot of people.”14 In her first interview with Mr.
    Beyer, Mother acknowledged that she takes prescription medication for her anger and
    frustration, but she could not recall the name of the medication. In her second interview,
    when Mr. Beyer asked if Mother had ever been diagnosed with a mental health disorder,
    she stated, “[n]ot that I know of.” However, after Mr. Beyer’s follow-up question
    concerning whether Mother had ever been prescribed medication for a mental health
    disorder, she responded: “No, well Carey Counseling prescribed me medicine for
    depression. . . . I don’t remember the pills.” Though she stated that she took her medication
    daily, Mother could not recall the name of said medication. At trial, Mother testified that
    she takes medication for depression and for nightmares, but she could not remember the
    name of either. Mother was able to recall that she takes Trazodone for sleep.15
    Clearly, Mother suffers from a mental impairment. Thus, the question becomes
    whether Mother’s impairment adversely affects her ability to parent. We conclude that it
    does. As the trial court found, Mr. Beyer acknowledged in Mother’s follow-up evaluation
    that, even after one year of supportive services, Mother is not “capable of [the] mature and
    rational decision-making required to provide for the day to day care of her children.” As
    discussed at length, supra, Mother lacks the ability to provide for her own basic needs, let
    alone the needs of three children. Further, her mental impairment prevents her from
    making appropriate decisions for herself and the Children. For example, Mother still
    struggles to use good judgment to identify safe and supportive relationships. Despite
    discussions with her providers concerning Mother’s safety and well-being, she continues
    14
    It remains unclear from the record why Mother receives social security disability benefits.
    15
    Trazodone is a medication often used to treat depression. Trazodone HCL, WEBMD.COM,
    https://www.webmd.com/drugs/2/drug-11188/trazodone-oral/details (last visited December 16, 2020).
    - 22 -
    to engage in short-term romantic relationships with men she just met. While Mother admits
    that it would be inappropriate for the Children to be around many of these men, she
    nevertheless relies on them for support.
    Mother’s mental impairment also affects her ability to maintain employment and to
    make good, stable financial decisions. Despite working with multiple service providers on
    this issue, Mother cannot manage her finances. From the testimony of Ms. Affolter and
    Ms. Fries, it appears Mother is unable to, (1) prioritize how she spends her money, and (2)
    learn from past financial mistakes. For example, the record demonstrates that, rather than
    provide for her own basic needs, Mother continually spends money on her pets. At trial,
    Mother testified that she would not rehome her animals because they are “like children” to
    her. What Mother fails to recognize and appreciate is that spending much of her limited
    income on her pets contributes to her inability to resume custody of her children.
    Additionally, Mother’s mental impairment affects her ability to care for the
    Children’s physical needs. As Mr. Beyer observed in his follow-up evaluation, Mother did
    “not appear to be capable of meeting the [C]hildren’s physical needs” because she failed
    to demonstrate “competency of skills taught her, [instead] requir[ing] prompting from
    others and guidance to initiate nurturing of the [C]hildren.” Ms. Affolter’s testimony that,
    during supervised visits with the Children, she often had to prompt Mother to engage with
    the Children in a safe and appropriate manner, substantiates Mr. Beyer’s observation.
    Finally, Mother’s own testimony exemplifies that she is simply unable to
    comprehend the type of support and stability the Children require. When asked at trial if
    Mother understood that “Amber was concerned about [Mother]’s ability to provide for [the
    Children],” Mother answered: “I always buy for them when they’re with me . . . I know I
    [provide for them]. I make sure they have their food and everything that they need.” In
    Mother’s mind, she has always provided for the Children, despite experiencing periods of
    homelessness where the family was without food or shelter. Indeed, at the time of trial,
    despite living in the home of a man she barely knows, despite running out of money mid-
    month, despite having no savings, and despite living in a home that smelled of animal urine,
    Mother testified that she had established a suitable home for the Children.
    Unfortunately, it appears that Mother’s mental condition is likely to remain
    impaired such that it is unlikely she will ever be able to resume care of and responsibility
    for the Children. 
    Tenn. Code Ann. § 36-1-113
    (g)(8)(B)(i). In his second evaluation, Mr.
    Beyer explained that the minimum goals Mother should reach to be able to safely parent
    the Children were, in part, to “be able to be self-supportive or be willing to accept the need
    for support from family members to assist her and be able to reside with them without
    undue conflict.”16 Mr. Beyer noted that Mother’s prognosis for functioning independently
    16
    As discussed, supra, because of Mother’s tumultuous relationship with her family, DCS
    encouraged Mother to look to friends for support.
    - 23 -
    remained poor. He explained that “[h]er intellectual functioning has remained consistently
    impaired and there is little indication that this will change given more time.”
    Unfortunately, perhaps due to her mood disorders, Mother has been unable to enlist
    appropriate sources of support for both herself and the Children. As a result, it is unlikely
    Mother will ever be able to resume care of the Children.
    The confluence of Mother’s intellectual disability and mood disorders prevents her
    from being able to achieve the stability necessary to properly and safely parent the
    Children. While Mother’s intellectual disability precludes her from living independently,
    supporting herself, and trusting others, Mother’s mood disorders preclude her from
    responding appropriately when confused, frustrated, or faced with stressful situations. As
    a result, as seen throughout this case, Mother is unable to find the support, and often rejects
    the help, she most desperately needs. While Mother’s failure to provide the Children with
    proper care and supervision is likely not willful, willfulness need not be shown under this
    ground. 
    Tenn. Code Ann. § 36-1-113
    (g)(8)(C). Rather, because “[t]he statute serves to
    protect children from harm caused by a parent who is incapable of safely caring for them,”
    our question is “whether the children would be able to safely live with the parent[].” In re
    Samuel R., No. W2017-01359-COA-R3-PT, 
    2018 WL 2203226
    , at *9 (Tenn. Ct. App.
    May 14, 2018), perm. app. denied (Aug. 13, 2018) (internal citations omitted). We
    conclude that it would be detrimental to the safety and welfare of the Children to be placed
    with Mother. There is clear and convincing evidence that Mother’s intellectual disability
    as well as her mood disorders prevent her from safely caring for herself or the Children.
    Further, we conclude that there is clear and convincing evidence that Mother will likely
    suffer from her disability and mood disorders for the rest of her life, preventing her from
    ever resuming care of the Children. In Department of Children’s Services v. Mims, we
    concluded that termination of a father’s parental rights was appropriate under a similar
    scenario where a father was “unable to maintain regular employment, unable to support his
    children, and unable to obtain a home suitable for the family.” State, Dep’t of Children’s
    Servs. v. Mims, 
    285 S.W.3d 435
    , 449 (Tenn. Ct. App. 2008); see also In re Katrina S.,
    
    2020 WL 5269236
    , at *10 (terminating a mother’s parental rights where the mother
    required a conservator to manage her finances, and where the mother admitted that she
    could not follow the directions of nurses or doctors and required another adult to attend
    doctor’s appointments with her). Accordingly, we conclude there is clear and convincing
    evidence to support the trial court’s termination of Mother’s parental rights as to the ground
    of mental incompetence.
    E. Best Interest
    When at least one ground for termination of parental rights has been established, the
    petitioner must then prove, by clear and convincing evidence, that termination of the
    parent’s rights is in the children’s best interest. In re Bernard T., 
    319 S.W.3d at
    606 (citing
    In re Adoption of A.M.H., 
    215 S.W.3d at 809
    ).
    - 24 -
    As the Tennessee Supreme Court explained:
    Facts considered in the best interest analysis must be proven by “a
    preponderance of the evidence, not by clear and convincing evidence.” In
    re Kaliyah S., 455 S.W.3d at 555 (citing In re Audrey S., 
    182 S.W.3d at 861
    ). “After making the underlying factual findings, the trial court should
    then consider the combined weight of those facts to determine whether they
    amount to clear and convincing evidence that termination is in the child’s
    best interest[s].” 
    Id.
     When considering these statutory factors, courts must
    remember that “[t]he child’s best interests [are] viewed from the child’s,
    rather than the parent’s, perspective.” In re Audrey S., 
    182 S.W.3d at 878
    .
    Indeed, “[a] focus on the perspective of the child is the common theme”
    evident in all of the statutory factors. 
    Id.
     “[W]hen the best interests of the
    child and those of the adults are in conflict, such conflict shall always be
    resolved to favor the rights and the best interests of the child. . . .” 
    Tenn. Code Ann. § 36-1-101
    (d)(2017).
    In re Gabriella D., 
    531 S.W.3d 662
    , 681-82 (Tenn. 2017).
    The Tennessee Legislature has codified certain factors that courts should consider
    in ascertaining the best interest of the child in a termination of parental rights case. As is
    relevant to this appeal, these factors include, but are not limited to, the following:
    (1) Whether the parent or guardian has made such an adjustment of
    circumstance, conduct, or conditions as to make it safe and in the child’s best
    interest to be in the home of the parent or guardian;
    (2) Whether the parent or guardian has failed to effect a lasting adjustment
    after reasonable efforts by available social services agencies for such
    duration of time that lasting adjustment does not reasonably appear possible;
    (3) Whether the parent or guardian has maintained regular visitation or other
    contact with the child;
    (4) Whether a meaningful relationship has otherwise been established
    between the parent or guardian and the child;
    (5) The effect a change of caretakers and physical environment is likely to
    have on the child’s emotional, psychological and medical condition;
    (6) Whether the parent or guardian, or other person residing with the parent
    or guardian, has shown brutality, physical, sexual, emotional or
    psychological abuse, or neglect toward the child, or another child or adult in
    - 25 -
    the family or household;
    (7) Whether the physical environment of the parent’s or guardian’s home is
    healthy and safe, whether there is criminal activity in the home, or whether
    there is such use of alcohol, controlled substances or controlled substance
    analogues as may render the parent or guardian consistently unable to care
    for the child in a safe and stable manner;
    (8) Whether the parent’s or guardian’s mental and/or emotional status would
    be detrimental to the child or prevent the parent or guardian from effectively
    providing safe and stable care and supervision for the child . . . .
    (9) Whether the parent or guardian has paid child support consistent with the
    child support guidelines promulgated by the department pursuant to § 36-5-
    101.
    
    Tenn. Code Ann. § 36-1-113
    (i). This Court has noted that “this list [of factors] is not
    exhaustive, and the statute does not require a trial court to find the existence of each
    enumerated factor before it may conclude that terminating a parent’s rights is in the best
    interest of a child.” In re M.A.R., 
    183 S.W.3d 652
    , 667 (Tenn. Ct. App. 2005), perm. app.
    denied (Tenn. Nov. 21, 2005). Depending on the circumstances of an individual case, the
    consideration of a single factor or other facts outside the enumerated, statutory factors may
    dictate the outcome of the best interest analysis. In re Audrey S., 
    182 S.W.3d at 877
    . As
    explained by this Court:
    Ascertaining a child’s best interests . . . does not call for a rote examination
    of each of 
    Tenn. Code Ann. § 36-1-113
    (i)’s nine factors and then a
    determination of whether the sum of the factors tips in favor of or against the
    parent. The relevancy and weight to be given each factor depends on the
    unique facts of each case. Thus, depending upon the circumstances of a
    particular child and a particular parent, the consideration of one factor may
    very well dictate the outcome of the analysis.
    White v. Moody, 
    171 S.W.3d 187
    , 194 (Tenn. Ct. App. 1994).
    In its order terminating Mother’s parental rights, the trial court specifically
    considered each of the foregoing statutory factors and found that each weighed against
    Mother. Specifically, the trial court found:
    (1) [Mother has] not made any adjustment of circumstance[,] conduct[,] or
    conditions to make it safe and in the [Children’s] best interest to be in [her
    home].
    - 26 -
    (2) [Mother has] failed to effect any adjustment after reasonable efforts by
    [DCS] for almost 2 years. A lasting adjustment does not reasonably appear
    possible.
    (3) Mother has maintained regular visitation with at least two of the Children
    and, although the Children love her, they do not want to live with her.
    (4) A meaningful relationship has not otherwise been established.
    (5) A change of caregivers and physical environment would likely have a
    detrimental emotional, psychological and medical [effect] on the Children.
    (6) No one lives with Mother. . . .
    (7) The physical environment of [M]other’s home is not healthy or safe
    because of [M]other’s inability to make logical and rational decisions
    concerning the Children. There is no proof of controlled substances or
    alcohol in Mother’s home.
    (8) Mother’s mental and/or emotional status would be detrimental and,
    possibly dangerous, to the Children and would prevent [her] from effectively
    providing safe and stable care and supervision [of] the Children.
    (9) [Mother] [has not] paid any child support.
    For many of the reasons discussed above, the record supports the trial court’s
    finding that termination of Mother’s parental rights is in the Children’s best interests.
    Despite noteworthy assistance from DCS, Mother has failed to remedy any of the
    conditions that led to the Children’s removal. Mother does not have a permanent residence
    for the Children to return to, and her intellectual disability, in connection with her mood
    disorders, prevent her from being able to provide a safe and stable environment for the
    Children. While the record demonstrates that Mother loves the Children and maintained
    her visits with them, it is clear that she is unable to be the stable and supportive parent the
    Children deserve.
    Indeed, it is clear from the record that the Children already suffer from mental health
    issues of their own as a result of Mother’s care. Laura Tony, Amber’s therapist, diagnosed
    Amber with post-traumatic stress disorder, the underlying trauma being abuse/neglect from
    Mother.17 While Amber has completed her trauma-focused therapy, she is still undergoing
    17
    Aside from the evidence in the record that the Children were often homeless and without food,
    disturbingly, Amber also reported to Ms. Tony that there was at least one occasion where Mother had sex
    while the child was in the room. Amber also suffered trauma from watching Mother fight with others and
    - 27 -
    cognitive behavioral therapy, where she is making “wonderful progress.” Amber has
    expressed to Ms. Tony, her gratitude that she “no longer has to worry about if she will be
    able to get to school on time or to have food or clothes to wear or where she will sleep at
    night.” Amber has further expressed that, while she loves Mother, and wants Mother to be
    happy, she does not want to live with Mother because she is afraid Mother will become
    angry with her. Despite being removed from Mother’s custody, it appears Amber continues
    to fear Mother. Ms. Tony testified that Amber exhibited minor behavioral issues
    surrounding her visits or telephone calls with Mother, and Amber did not want to
    participate in same. Similarly, Desiree M., the Children’s foster mother at the time of trial,
    testified that Amber had nightmares the nights before or had small behavioral issues at
    school the day of or day before she visited Mother. The foregoing substantiates Ms. Tony’s
    testimony that it would be detrimental to Amber’s health and well-being to be returned to
    Mother’s care. The record shows that Amber is not the only child who exhibited behavioral
    issues prior to visiting with Mother. According to Ms. M., Ashley cried for considerable
    portions of the day before her scheduled visits with Mother and would also cry the day
    before a scheduled telephone call with Mother.
    As discussed at length, supra, Mother is unable to provide the Children with a safe
    and stable environment. Contrastingly, the record shows that the Children are in a safe and
    stable pre-adoptive home, and that Amber is making positive progress with her mental
    health treatment.18 Placing the Children in Mother’s care would almost certainly have a
    detrimental effect on the Children’s physical, emotional, and psychological well-being.
    For these reasons, we conclude there is clear and convincing evidence that termination of
    Mother’s parental rights is in the Children’s best interests.
    V. Conclusion
    For the foregoing reasons, we affirm the trial court’s order terminating Appellant’s
    parental rights to the Children. The case is remanded for such further proceedings as may
    be necessary and are consistent with this opinion. Costs of the appeal are assessed to the
    Appellant, Latoya R. Because Latoya R. is proceeding in forma pauperis in this appeal,
    execution for costs may issue if necessary.
    s/ Kenny Armstrong
    KENNY ARMSTRONG, JUDGE
    from watching the police take Mother away.
    18
    We note that the Children have changed residences since trial. According to the GAL at oral
    argument, all three Children currently reside together in a new pre-adoptive home.
    - 28 -