In Re: Michael B., Jr. ( 2017 )


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  •                                                                                                       08/11/2017
    IN THE COURT OF APPEALS OF TENNESSEE
    AT KNOXVILLE
    Assigned on Briefs July 3, 2017
    IN RE MICHAEL B., JR., ET AL
    Appeal from the Juvenile Court for Washington County
    No. 46-509, 46-510 Sharon M. Green, Judge
    ___________________________________
    No. E2017-00486-COA-R3-PT
    ___________________________________
    The trial court found clear and convincing evidence to terminate Mother’s parental rights
    to her two children on the grounds of abandonment by failure to establish a suitable
    home, substantial noncompliance with permanency plans, and persistence of conditions.
    The trial court also found clear and convincing evidence that termination was in the
    children’s best interest. Discerning no error, we affirm.
    Tenn. R. App. P. 3 Appeal as of Right; Judgment of the Juvenile Court Affirmed
    J. STEVEN STAFFORD, P.J.,W.S., delivered the opinion of the court, in which D. MICHAEL
    SWINEY, C.J., and ANDY D. BENNETT, J., joined.
    Holly L. Booksh, Johnson City, Tennessee, for the appellant, Felicia A.
    Herbert H. Slatery, III, Attorney General and Reporter; W. Derek Green, Assistant
    Attorney General, for the appellee, Tennessee Department of Children’s Services.
    OPINION
    Background
    On December 23, 2015, Petitioner/Appellee the Tennessee Department of
    Children’s Services (“DCS”) filed a petition to terminate the parental rights of Felicia A.
    (“Mother”) to her children, Michael B. and Melody B.,1 born in 2003.2 The petition
    alleged that the juvenile court had entered an order awarding DCS temporary legal
    custody of the children on January 7, 2015 and subsequently found the children to be
    1
    In cases involving termination of parental rights, it is the policy of this Court to remove the
    names of minor children and other parties in order to protect their identities.
    2
    The children’s father surrendered his parental rights and is not at issue in this appeal.
    dependent and neglected by order of March 16, 2015. The petition alleged grounds of
    abandonment by failure to establish a suitable home, substantial noncompliance with
    permanency plans, and persistence of conditions.
    The trial court thereafter appointed a guardian ad litem for the children and an
    attorney for Mother. On June 2, 2016, Mother filed a response in opposition to the
    termination petition. A trial took place over three days in December 2016 and January
    2017. Two permanency plans drafted by DCS, agreed to by Mother, and ratified by the
    trial court were entered as exhibits. The first plan, created and ratified in April 2015,
    required that Mother: (1) complete a clinical parenting assessment, inform DCS of the
    results, follow all recommendations, and provide documentation of any completion of
    recommendations to DCS; (2) attend visitation and display “learned parenting skills”; (3)
    complete a psychological assessment, share the results with DCS, follow all
    recommendations, and provide documentation of any completion of recommendations to
    DCS; (4) complete an alcohol and drug assessment, inform DCS of the results, follow all
    recommendations, and provide documentation of any completion of recommendations to
    DCS; (5) complete intensive outpatient alcohol and drug treatment and follow any
    recommendations from any drug treatment program; (6) submit to random drug screens;
    (7) obtain legal income or government assistance to provide for the children; (8) obtain
    documentation regarding any medical issues that would prevent employment; (9) seek
    help from DCS to apply for disability; and finally, (10) participate in homemaker services
    provided by DCS and provide a safe and clutter-free home for the children. A second
    parenting plan was created in August 2015 and ratified in October 2015. This plan
    generally contained the same requirements for Mother, with the addition of obtaining
    additional mental health, teen parenting, and anger management counseling.
    Nine DCS workers, service providers, or therapists testified on behalf of DCS
    regarding their involvement with the family. First, Julie Lowry, a DCS investigator and
    former assessment worker, testified that Mother and the children first became involved
    with DCS in 2012, but that case was ultimately closed. The instant matter instead began
    in July 2014 when DCS received a referral regarding the condition of the family’s home
    and the children not attending school due to having head lice. Throughout DCS’s
    involvement, Mother lived in a home owned by Mother’s father and later inherited by
    Mother.3 Ms. Lowry conducted ten home visits of Mother’s home between July 2014 and
    January 2015. During these visits, Ms. Lowry and other workers observed dog feces and
    garbage throughout the home, roaches and other bugs, mold, excessive clutter, gaps in the
    walls of the home, lack of food, and lack of heat in some places.
    Another DCS worker visited the home after the removal of the children, Jessica
    Trivette. Of Ms. Trivette’s ten attempted visits, Mother cancelled or was not present for
    3
    As discussed in detail, infra, for a time in the summer of 2015, Mother lived with her sister or
    brother due to the condition of the home being unsuitable.
    -2-
    at least half of the visits.4 Ms. Trivette testified that when she was able to view the home,
    its condition was largely unchanged, with some improvement that later “digressed.”
    Indeed, it was undisputed at trial that the home currently had no working electricity.
    The final DCS caseworker to be placed on this case, Diana McKamey, testified
    that she made eight unsuccessful attempts to inspect the home in 2016. Ms. McKamey
    made one successful home visit in September 2016; during this visit, the electricity in the
    home did not work and Ms. McKamey observed that the home was dirty, that there were
    “lots of bugs,” and that old food was left on the porch of the home.
    Much of the DCS workers’ testimony concerned their inability to maintain contact
    with Mother. Over the course of the time of DCS’s involvement, Mother had several
    telephone numbers and sometimes resided with her sister or brother for months at a time.
    DCS workers and service providers testified that they called and texted Mother’s
    numbers, as well as the numbers for Mother’s fiancé, father, and sister, often to no avail.
    On multiple occasions, DCS workers went to Mother’s home. Because Mother was often
    not home,5 they left notes for Mother. Sometimes, Mother would make contact with DCS
    following these attempts; sometimes Mother would not. Ms. Trivette testified that
    although Mother maintained consistent contact with her shortly following the removal of
    the children in January 2015, her ability to successfully contact Mother waned. As such,
    Ms. Trivette testified that she was completely unable to speak with Mother between April
    28, 2015 and June 17, 2015, despite repeated attempts. Shortly before trial on the
    termination petition began, Ms. McKamey also testified that she struggled to reach
    Mother. When she did contact mother in November 2016 and made recommendations,
    Mother rebuffed Ms. McKamey’s suggestions as “crap” that Mother did not need.
    Although Mother was informed that a family team meeting was taking place days before
    the trial in December 2016, Mother refused offers for transportation assistance and did
    not attend the meeting.
    Several DCS workers also testified about Mother’s drug abuse. Mother was
    administered a number of drug tests over the years of DCS’s involvement. Although
    Mother sometimes passed drug tests, DCS workers testified that Mother failed drug
    screens both prior to the removal of the children and later in January 2015, April 2015,
    March 2016, and December 2016, variously for marijuana, oxycodone, lortab,
    amphetamines, cocaine, opiates, bonxoylecgonine, morphine, oxymorphine, oxycodone,
    and hydrocodone. Frequently, Mother also failed to report for scheduled drug testing. In
    October 2015 and March 2016, Mother admitted to using illegal drugs. Even at the time
    of trial at the end of January 2017, Mother admitted that she likely could not pass a drug
    4
    Of the ten visits, Mother cancelled one visit, Mother was not home even though a visit was
    scheduled for two visits, and Mother was not home for three unscheduled visits.
    5
    Interestingly, the DCS workers were often informed that Mother was out doing laundry when
    they called at the home. Mother testified at trial, however, that the home has laundry facilities.
    -3-
    test because she had used marijuana three weeks prior. Mother claimed to have
    prescriptions for some of the medications for which she tested positive, but DCS workers
    testified that they never received proof of the prescriptions and no documentation was
    submitted during trial to support Mother’s claims.
    In order to combat Mother’s mental health and substance abuse issues, DCS
    provided Mother with several assessments, which were completed by Mother, and several
    treatment options, none of which had been successfully completed by the time of trial.
    After Mother’s completion of an alcohol and drug assessment in April 2015, it was
    recommended that Mother attend intensive outpatient alcohol and drug treatment. Mother
    enrolled in a program in April 2015, but terminated her participation that summer stating
    that the program “was not for me.” Mother also successfully completed a clinical
    parenting assessment in April 2015. A psychological assessment was scheduled for early
    April 2015, but Mother did not appear. The assessment was eventually completed in June
    2015.
    Pursuant to the recommendations from the assessments, DCS set up in-home
    alcohol and drug treatment services for Mother, beginning in August 2015. Mother was
    required to simply be home to receive the services when scheduled. Despite this minimal
    effort required of Mother, Mother was home to complete services only for four out of ten
    scheduled services. As such, the service provider testified that Mother made no
    significant progress. These services were terminated in September 2015 due to Mother’s
    noncompliance. Although services were reauthorized by DCS in September 2016—this
    time to be completed inpatient—the service provider testified that he was unable to
    obtain contact with Mother to initiate the services. Mother testified that her failure to
    complete services with this provider related to her dislike of the service provider, who
    she claimed attempted to perform services at inappropriate times and locations.
    DCS also referred Mother to three different inpatient drug treatment programs
    after Mother admitted to relapsing in October 2015. DCS first referred Mother to the
    Magnolia Ridge treatment program where Mother was placed on the waiting list. At trial,
    Mother claimed to still be on the waiting list even though years had passed. When asked
    what effort Mother had made to attend treatment at Magnolia Ridge, Mother admitted
    that she had not really thought about it for some time. In the same month, Mother left a
    second treatment program, scheduled to take at least twelve days to complete, after two
    days due to medical issues; Mother never returned. Mother claimed that she attempted to
    return but was unable to do so because there was a miscommunication regarding her
    transportation. After this missed attempt, however, it does not appear that Mother made
    another effort to return to this program. Mother blamed her failure to make additional
    effort to return on the death of her father, which occurred approximately two months later
    in January 2016. As previously discussed, DCS authorized Mother’s attendance at
    another inpatient program in September 2016, but Mother missed her first appointment
    -4-
    and thereafter failed to reschedule the appointment or otherwise maintain contact with the
    service provider.
    Due to the issues with Mother’s home, DCS also provided Mother with
    homemaker and parenting services through Foundations for Life Principles, beginning in
    April 2015. Rebecca Roosa, who began working with Mother in September 2015,
    testified that her purpose was to help Mother with cleaning and de-cluttering the home,
    managing medications, applying for jobs, obtaining transportation or learning to use
    public transportation, filing for disability benefits, going to mental health appointments,
    and helping Mother regain electricity in the home. Foundations for Life also provided
    Mother with parenting education. In order to receive these services, Mother only had to
    be available in her home. Nevertheless, Mother often missed appointments and Ms.
    Roosa was unable to maintain consistent contact with Mother. Foundations for Life
    services were eventually terminated in December 2015 based on Mother’s
    noncompliance.
    At trial, Mother testified that her substance abuse issues stemmed from mental
    issues related to grief and stress. Mother denied, however, that she was “self-medicating.”
    Mother identified several stressful events during the course of DCS’s involvement in this
    case, including: (1) the death of Mother’s sister in February 2015; (2) the death of
    Mother’s father in January 2016; (3) Mother’s unplanned pregnancy in the spring of
    2016; and (4) the death of Mother’s infant in September 2016. According to Mother, she
    had not had time to grieve the death of her child and she was unable to make progress due
    to the stressful events in her life. At the time of trial, Mother testified that she had
    recently enrolled in motivational and parenting classes and had begun case management
    at a mental health facility. Mother testified, however, that she had attended only a single
    class at the time of her testimony.
    Mother indicated that she was not currently employed and that at the time of the
    final day of trial, over four months had passed from the death of her child, with very little
    progress made on the tasks required to be completed by Mother. Mother stated that she
    suffered from a serious condition often affecting her health, but did not testify that this
    condition made her unable to maintain employment. Indeed, Mother testified that she had
    worked for approximately one month at a fast food restaurant and that she was planning
    to begin working at another restaurant soon. Mother admitted that her home currently had
    no electricity and indeed had not had working electricity as early as May 2016. Around
    May 2016, Mother testified that she became aware that she pregnant unexpectedly, which
    caused her some mental health issues. Due to the pregnancy and the lack of electricity,
    Mother spent considerable time in the summer of 2016 living with her brother or sister.
    At this time, DCS workers had difficulty contacting Mother. Mother testified, however,
    that she was home approximately three nights per week and that she informed DCS of her
    temporary move, albeit later in the summer of 2016. Mother also stated that she would
    -5-
    be able to turn on the electricity in the home once she received her tax return in early
    2017.
    With regard to income at the time of trial, Mother testified that she sometimes
    works as a care-giver for adults and that her fiancé works as well. Additionally, prior to
    his death, Mother testified that her father helped her financially. Mother admitted that
    despite being required to do so in the permanency plan, she had not paid child support for
    the children.
    Mother testified that she consistently attended visitation until the terms were
    changed making it more difficult to schedule the visits. At trial, the evidence showed that
    other than a few missed or rescheduled visitations, Mother had visited with the children
    often and typically consistently. Mother and those who witnessed visitation both testified
    that Mother had a strong and loving bond with the children. A service provider who
    witnessed visitation testified that Mother sometimes brought others to the visitation, but
    stopped this behavior when asked. The service provider also testified that Mother
    sometimes spoke of topics such as the litigation and was required to be redirected. The
    service provider admitted, however, that often the children had to be redirected from
    certain topics as well. Based solely on the visits, the service provider provided Mother
    with periodic progress reports indicating that there were no safety issues that would
    prevent reunification. The service provider also testified that there was no impediment to
    unsupervised visitation with the children should the termination petition not be granted.
    The children’s therapists and foster mother both testified about the children’s
    progress after their removal. The children’s therapists both testified that the children were
    making progress, but still had issues that required consistent therapy. Michael’s therapist
    indicated that his need for stability was great and that he needs things to be settled with
    Mother “one way or the other.” Melody’s therapist testified that she suffers from stress
    related to being removed from her biological family and that her treatment focuses on
    accepting the circumstances as they are. Although Melody was only placed in therapy
    after the removal, Mother had engaged a therapist for Michael while he was still in her
    custody to treat his attention deficit hyperactivity disorder.
    The children’s therapeutic foster mother testified that she was trained to provide
    additional in-home therapeutic care for the children. Although there had been an issue
    with Michael’s behavior that had caused the children to be removed from foster mother’s
    care for a time, the children had returned to foster mother’s care, in part because the
    children wanted to return. Foster mother testified that the children were making
    improvements and that her family was open to adopting the children should termination
    be granted. Foster mother testified that the children are doing well and making
    improvements, but that they are disappointed when Mother misses scheduled telephone
    calls or is distracted by other individuals during the phone calls. At least once, foster
    mother testified that she believed Mother to be under the influence during a phone call.
    -6-
    At the conclusion of trial, the trial court orally ruled in favor of DCS. Thereafter,
    on February 9, 2017, the trial court entered a detailed and thorough order finding that
    DCS had established clear and convincing evidence of Mother’s failure to establish a
    suitable home, Mother’s substantial noncompliance with permanency plans, and
    persistence of conditions. The trial court likewise found clear and convincing evidence
    that termination was in the children’s best interests.
    Issues Presented
    Mother raises four issues in this case, which we summarize:
    1. Whether the trial court erred in finding clear and convincing evidence that grounds
    existed to terminate Mother’s parental rights.
    2. Whether the trial court erred in finding clear and convincing evidence that
    termination was in the children’s best interest.
    Analysis
    According to the Tennessee Supreme Court:
    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 (2000); Stanley v. Illinois, 
    405 U.S. 645
    , 651
    (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 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 (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).
    Our termination statutes identify “those situations in which the 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)). A person seeking to terminate parental rights must prove both the existence of
    -7-
    one of the statutory grounds for termination and 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).
    Because of the fundamental nature of the parent’s rights and the grave
    consequences of the termination of those rights, courts must require a higher standard of
    proof in deciding termination cases. 
    Santosky, 455 U.S. at 769
    . Consequently, both the
    grounds for termination and the best interest inquiry must be established by clear and
    convincing evidence. Tenn. Code Ann. § 36-3-113(c)(1); 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 the evidence.” In re M.J.B., 
    140 S.W.3d 643
    , 653 (Tenn.
    Ct. App. 2004). Such evidence “produces in a fact-finder’s mind a firm belief or
    conviction regarding the truth of the facts sought to be established.” 
    Id. at 653.
    As our supreme court opined:
    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 [387,]
    393 [(Tenn. Ct. App. 2009)] (quoting In re Adoption of A.M.H., 215
    S.W.3d [793], 810 [(Tenn. 2007)]). 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
    .
    Carrington H., 
    2016 WL 819593
    , at *12.
    When the resolution of an issue in a case depends upon the truthfulness of
    witnesses, the trial judge, who has had the opportunity to observe the witnesses and their
    manner and demeanor while testifying, is in a far better position than this Court to decide
    those issues. See McCaleb v. Saturn Corp., 
    910 S.W.2d 412
    , 415 (Tenn. 1995);
    Whitaker v. Whitaker, 
    957 S.W.2d 834
    , 837 (Tenn. Ct. App. 1997). The weight, faith,
    and credit to be given to any witness’s testimony lies in the first instance with the trier of
    fact, and the credibility accorded will be given great weight by the appellate court.
    Walton v. Young, 
    950 S.W.2d 956
    , 959 (Tenn. 1997).
    Grounds for Termination
    The trial court found three grounds for terminating Mother’s parental rights: (1)
    abandonment by failure to establish a suitable home pursuant to Tennessee Code
    Annotated section 36-1-102(1)(A)(ii); (2) persistence of conditions pursuant to Tennessee
    Code Annotated section 36-1-113(g)(3); and (3) substantial noncompliance with the
    -8-
    permanency plans pursuant to Tennessee Code Annotated section 36-1-113(g)(2). We
    begin with abandonment by failure to establish a suitable home.
    Abandonment by Failure to Establish a Suitable Home
    Pursuant to Tennessee Code Annotated section 36-1-113(g)(1), “[a]bandonment
    by the parent or guardian” constitutes a ground for termination of a parent’s parental
    rights. Tennessee Code Annotated section 36-1-102, in turn, provides several definitions
    for abandonment. In this case, the petition alleged, and the trial court found,
    abandonment by failure to establish a suitable home under Tennessee Code Annotated
    section 36-1-102(1)(A)(ii). This section provides that abandonment may be found where:
    The child has been removed from the home of the parent or parents or the
    guardian or guardians as the result of a petition filed in the juvenile court in
    which the child was found to be a dependent and neglected child, as defined
    in § 37-1-102, and the child was placed in the custody of the department or
    a licensed child-placing agency, that 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 for a period of four (4) months following the removal, the
    department or agency has made reasonable efforts to assist the parent or
    parents or the guardian or guardians to establish a suitable home for the
    child, but that the parent or parents or the guardian or guardians have made
    no reasonable efforts to provide a suitable home and have 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.
    
    Id. A suitable
    home “requires more than a proper physical living location.” In re Hannah
    H., No. E2013-01211-COA-R3-PT, 
    2014 WL 2587397
    , at *9 (Tenn. Ct. App. June 10,
    2014) (quoting State v. C.W., No. E2007-00561-COA-R3-PT, 
    2007 WL 4207941
    , at *3
    (Tenn. Ct. App. Nov. 29, 2007)). “It requires that the home be free of drugs and domestic
    violence.” 
    Id. Here, there
    is no dispute that the children were placed in DCS custody on January
    7, 2015 and later found to be dependent and neglected. There also can be little dispute
    that Mother’s home remains unsuitable for the children. According to Mother’s own
    admission, it lacks basic necessities such as electricity. Indeed, Mother testified that she
    often could not stay in the home during her pregnancy due to the lack of electricity. As
    such, it appears largely uncontested that the children likewise cannot stay in the home in
    its current condition, despite Mother’s testimony that some improvements were being
    made to the home.
    -9-
    Rather, Mother asserts that the trial court erred in finding that DCS made
    reasonable efforts to assist Mother with improving the home’s condition in the four
    months following the children’s removal. This Court has previously held that this ground
    for termination required clear and convincing proof that “DCS ‘made reasonable efforts
    to assist [Mother] to establish a suitable home for the child[.]’” In re Josephine E.M.C.,
    No. E2013-02040-COA-R3-PT, 
    2014 WL 1515485
    , at *19 (Tenn. Ct. App. Apr. 17,
    2014) (quoting Tenn. Code Ann. § 36-1-102(a)(1)(A)). Pursuant to section 36-1-
    102(1)(A)(ii): “The efforts of the department or agency to assist a parent or guardian in
    establishing a suitable home for the child may be found to be reasonable if such efforts
    exceed the efforts of the parent or guardian toward the same goal, when the parent or
    guardian is aware that the child is in the custody of the department[.]” Therefore, DCS’s
    “efforts do not need to be ‘Herculean,’ [but] DCS is required to use its ‘superior insight
    and training to assist parents with the problems the Department has identified in the
    permanency plan, whether the parents ask for assistance or not.’” In re Isobel V.O., No.
    M2012-00150-COA-R3-PT, 
    2012 WL 5471423
    , at *8 (Tenn. Ct. App. Nov. 8, 2012)
    (quoting State, Dep’t. of Children’s Servs. v. Estes, 
    284 S.W.3d 790
    , 800–801 (Tenn. Ct.
    App. 2008)). This Court has interpreted Tennessee Code Annotated section 36-1-
    102(1)(A)(ii) as directing that a reasonable efforts inquiry in this context be limited to an
    examination of the four-month period immediately following the child’s removal from
    the home. See, e.g., In re Riley C., No. M2015-00541-COA-R3-PT, 
    2016 WL 626058
    , at
    *8 (Tenn. Ct. App. Feb. 12, 2016); In re M.A.P., No. E2014-02413-COA-R3-PT, 
    2016 WL 369399
    , at *5 (Tenn. Ct. App. Jan. 29, 2016); In re Aaliyah E., No. E2015-00602-
    COA-R3-PT, 
    2016 WL 304627
    , at *6 (Tenn. Ct. App. Jan. 26, 2016). The relevant period
    in this case therefore spans January 8, 2015 to May 7, 2016.
    Mother argues that because of DCS’s storied involvement in this case, DCS
    should have known that Mother’s “issues were not easily remedied.” Rather than
    immediately engage services to help Mother, she notes that DCS’s referrals largely did
    not begin until April 2015, more than two months after the children were removed. DCS
    does not dispute that there was some delay in providing necessary services to Mother, but
    asserts that some of the delay was attributable to communication issues with Mother and
    her decision to postpone assessments. Additionally, DCS asserts that its efforts, while
    somewhat delayed, were reasonable and constituted more effort than Mother expended to
    remedy the conditions that led to the removal of the children.
    Here, the trial court found that DCS did make reasonable efforts to assist Mother
    in establishing a suitable home in the four months following the removal of the children.
    The trial court noted that Ms. Trivette, inter alia, attempted to locate a relative placement
    for the child, assisted Mother in scheduling an alcohol and drug assessment, attempted to
    maintain contact with Mother, helped Mother reconnect with a previous service provider,
    provided random drug screening to help Mother show that she was drug-free, made a
    referral for a psychological assessment and reminded Mother of the appointment, which
    Mother later missed and Ms. Trivette helped her reschedule, requested funding for a
    - 10 -
    clinical parenting assessment, which was completed within the four-month period, made
    a referral for homemaking services to assist Mother with remedying the conditions in her
    home, conducted home visits to determine Mother’s progress, notified Mother of
    appointments for the children, and ensured that the children’s therapy remained near
    Mother’s home so that she could attend the sessions. In contrast, the trial court found that
    Mother made no real effort to establish a suitable home for the children. During this time,
    Mother tested positive for illegal substances. Mother often missed scheduled
    appointments with service providers and telephone calls with the children. Although
    Mother was largely consistent with visitation with the children, DCS workers testified
    time and again that they were often unable to stay in contact with Mother. As such, the
    trial court found that
    18. [W]hile not all of the recommendations of the assessments that were
    completed by [Mother] were returned during the four (4) months following
    removal, the reasonable efforts that were made by [DCS] during this four
    (4) month period were astronomical when compared to the minimal efforts
    made by [Mother] to improve her situation.
    19. [Mother]’s failure to make even minimal efforts to improve her home
    and personal condition demonstrates a lack of concern for the children to
    such a degree that it appears unlikely that she will be able to provide a
    suitable home for the children at an early date.
    The record on appeal supports the trial court’s finding that despite DCS’s
    reasonable efforts to assist Mother, she made no corresponding efforts to remedy her
    living situation. Here, Mother admits in her brief that Ms. Trivette, the DCS worker
    assigned to Mother during this time, spoke on the phone with Mother between January 7,
    2015 and the end of February and met with Mother in her home one time at the end of
    February. Still, we concede that much of DCS’s efforts came during the final months of
    the four-month period at issue. Nevertheless, in April 2015, DCS worked to assist Mother
    in obtaining necessary assessments and improving her home situation by placing
    homemaking services in the home with Mother. Clearly these efforts are far superior to
    other cases in which this Court found that no reasonable efforts were exerted by DCS. In
    Isobel V.O., for example, we held that DCS failed to prove by clear and convincing
    evidence that it used reasonable efforts to assist parents with establishing a suitable home
    where the only effort DCS made with respect to housing was to provide them with a list
    of possible housing options. In re Isobel V.O., 
    2012 WL 5471423
    , at *8. We have
    likewise found a lack of clear and convincing evidence of abandonment for failure to
    provide a suitable home where DCS “offered no evidence of efforts it made to help
    Mother obtain suitable housing at any time.” In re C.H.E.H., No. E2007-01863-COA-
    R3-PT, 
    2008 WL 465275
    , at *11 (Tenn. Ct. App. Feb.21, 2008). In this case, however,
    Ms. Trivette detailed a multitude of efforts expended to assist Mother in establishing a
    suitable home for her children. Ms. Roosa’s homemaker services also began during the
    four-month period and included effort to assist Mother in cleaning the home, obtaining
    - 11 -
    disability benefits or employment, attending mental health appointments, and learning
    public transportation to remedy Mother’s transportation issues.
    During this time, however, Mother continued to abuse drugs and made no
    improvement to her living situation. Even at the time of trial, the home had no electricity
    and Mother admitted that she had recently used illegal drugs. At trial, Mother asserted
    that work was currently being done to the home. As such, it appears that Mother wishes
    to chastise DCS for a an approximate three month delay in securing services for her with
    her approximately two-year delay in making in substantial effort to make the home
    liveable. This Court has previously upheld a trial court’s finding as to this ground even
    where DCS’s efforts are delayed when some of the delay is attributable to lack of contact
    with the parent. See In re Candace J., No. M2015-01406-COA-R3-PT, 
    2016 WL 944268
    , at *9 (Tenn. Ct. App. Mar. 11, 2016). In this case, Ms. Trivette testified to the
    multitude of efforts that DCS made during the four months following the removal of the
    children. Although these efforts largely began in the final two months, the Tennessee
    Legislature has clearly chosen to confine our review not to only the first two months after
    the removal, but the four months following removal. See Tenn. Code Ann. § 36-1-
    102(1)(A)(ii); In re Riley, 
    2016 WL 626058
    , at *8. The effort expended by DCS is
    therefore sufficient even though it occurred well into the four-month period at issue.
    Mother also asserts that this ground is inapplicable where she was unable to
    complete the recommended programs required by the permanency plan in the four-month
    period following the removal of the children. Effort, rather than completion, is the proper
    metric with regard to this ground. See Tenn. Code Ann. § 36-1-102(1)(A)(ii) (discussing
    the parents “efforts”). As detailed above, Mother made minimal effort during the four-
    month period to establish a suitable home for the children, or at the very least, to maintain
    contact with DCS so that it could provide services to help her achieve this goal.
    Moreover, Mother failed to complete the required drug and alcohol program not only in
    the four months after the removal of the children, but also in the approximately two years
    since the children were removed from her home. The trial court’s finding that the ground
    of abandonment by failure to establish a suitable home is therefore affirmed.
    Substantial Noncompliance
    Next, the trial court found that Mother had substantially failed to comply with the
    permanency plans at issue. Tennessee Code Annotated section 36-1-113(g)(4) provides
    that a ground for termination exists where “[t]here has been substantial noncompliance by
    the parent or guardian with the statement of responsibilities in a permanency plan
    pursuant to the provisions of title 37, chapter 2, part 4[.]” Further, Tennessee Code
    Annotated section 37-2-403 provides, in relevant part:
    Substantial noncompliance by the parent with the statement
    of responsibilities provides grounds for the termination of
    - 12 -
    parental rights, notwithstanding other statutory provisions for
    termination of parental rights, and notwithstanding the failure
    of the parent to sign or to agree to such statement if the court
    finds the parent was informed of its contents, and that the
    requirements of the statement are reasonable and are related
    to remedying the conditions that necessitate foster care
    placement.
    The determination of whether there has been substantial noncompliance with a
    permanency plan is a question of law, to be reviewed on appeal de novo with no
    presumption of correctness. In re Valentine, 
    79 S.W.3d 539
    , 548 (Tenn. 2002).
    Termination of parental rights under Tennessee Code Annotated section 36-1-113(g)(2)
    “requires more proof than that a parent has not complied with every jot and tittle of the
    permanency plan.” In re M.J.B., 
    140 S.W.3d 643
    , 656 (Tenn. Ct. App. 2004). To
    succeed under section 36-1-113(g)(2), DCS “must demonstrate first that the requirements
    of the permanency plan are 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 
    M.J.B., 140 S.W.3d at 656
    –57 (citing In re 
    Valentine, 79 S.W.3d at 547
    ; In re L.J.C., 
    124 S.W.3d 609
    , 621 (Tenn. Ct. App. 2003)). Second, DCS must show that “the parent’s
    noncompliance is substantial in light of the degree of noncompliance and the importance
    of the particular requirement that has not been met.” In re 
    M.J.B., 140 S.W.3d at 657
    (citing In re 
    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. June 3, 2003)).
    Here, there is no dispute that the permanency plans in this case required Mother
    to: (1) complete a clinical parenting assessment, inform DCS of the results, follow all
    recommendations, and provide documentation of any completion of recommendations to
    DCS; (2) attend visitation and display “learned parenting skills”; (3) complete a
    psychological assessment, share the results with DCS, follow all recommendations, and
    provide documentation of any completion of recommendations to DCS; (4) complete an
    alcohol and drug assessment, inform DCS of the results, follow all recommendations, and
    provide documentation of any completion of recommendations to DCS; (5) complete
    intensive outpatient alcohol and drug treatment and follow any recommendations from
    any drug treatment program; (6) submit to random drug screens; (7) obtain legal income
    or government assistance to provide for the children; (8) obtain documentation regarding
    any medical issues that would prevent employment; (9) seek help from DCS to apply for
    disability; and finally, (10) participate in homemaker services provided by DCS and
    provide a safe and clutter-free home for the children. At trial, Mother testified that she
    was informed of the requirements of the plans and the consequences of her failure to
    comply with the plans’ requirements. Having reviewed the plan, we affirm the trial
    court’s finding that the requirements of the plan were reasonably related to the conditions
    that led DCS to remove the children.
    - 13 -
    The trial court found that with the exception of maintaining regular visitation with
    the children and completing assessments, Mother “has not completed any of the tasks set
    out for her in the permanency plans, such that she is in substantial noncompliance with
    the same.” The evidence in the record supports the trial court’s findings. Mother was
    generally present for visitation and attended the children’s therapy sessions when
    appropriate. The record also shows that Mother did attempt to obtain disability benefits
    and completed three assessments: an alcohol and drug assessment, a mental health
    assessment, and a clinical parenting assessment. Although Mother completed these
    assessments, she generally failed to follow any of the recommendations that resulted.
    While Mother testified that her inability to complete alcohol and drug treatment or mental
    health treatment resulted from circumstances outside her control, for at least one type of
    alcohol and drug treatment, the only effort on Mother’s part was to be home at scheduled
    times. Mother failed to make even this minimal effort and in-home drug and alcohol
    treatment was eventually terminated.
    The permanency plans also required that Mother participate in in-home
    homemaking services. Again, despite the fact that all Mother was required to do was be
    present for the services, these services were eventually terminated due to Mother’s
    noncompliance. With regard to the requirement that Mother participate in drug screening,
    various DCS workers testified that Mother was often difficult or impossible to contact to
    set up drug screens, that she failed to appear for some scheduled screenings, and that she
    failed some screenings. Indeed, Mother admitted that she sometimes failed or missed
    scheduled drug screens, did not currently have employment, had failed to substantially
    complete an intensive inpatient or outpatient drug treatment program, and had missed
    scheduled appointments with the homemaker services resulting in the termination of
    those services. In addition, Mother admitted that despite the homemaker services, her
    home was still cluttered and without electricity.
    Although Mother made various excuses for her lack of completion of these tasks,
    again, our focus is not on whether Mother successfully met the goals of the permanency
    plan, but rather whether she made an effort to do so. When considering this ground for
    termination, “outcome achievement is not the measure of compliance[.]” In re B.D., No.
    M2008-01174-COA-R3-PT, 
    2009 WL 528922
    , at *8 (Tenn. Ct. App. Mar. 2, 2009). “Our
    focus is on the parent’s efforts to comply with the plan, not the achievement of the plan’s
    desired outcomes.” In re Aiden R., No. E2015-01799-COA-R3-PT, 
    2016 WL 3564313
    ,
    at *9 (Tenn. Ct. App. June 23, 2016) (no perm. app. filed); see In re Heaven J., No.
    W2016-00782-COA-R3-PT, 
    2016 WL 7421381
    , at *10–11 (Tenn. Ct. App. Dec. 22,
    2016) (holding that the evidence did not rise to the level of clear and convincing on the
    ground of substantial noncompliance when father made “considerable efforts and
    substantial progress” toward his tasks on the permanency plan); Tenn. Dep’t of
    Children’s Servs. v. P.M.T. et al., 
    2006 WL 2644373
    , at *8 (Tenn. Ct. App. 2006)
    (“Tenn[essee] Code Ann[otated section] 36-1-113(g)(2) does not require substantial
    compliance with a permanency plan’s ‘desired outcome[s],’ rather it requires substantial
    - 14 -
    compliance with a plan’s statement of responsibilities, i.e., the actions required to be
    taken by the parent or parents.”); cf. In re Eddie F., No. E2016-00547-COA-R3-PT,
    
    2016 WL 7029285
    , at *6 (Tenn. Ct. App. Dec. 2, 2016), app. denied (Tenn. Mar. 2,
    2017) (“Although [m]other certainly failed to comply with some requirements of the
    permanency plan, we cannot agree that [m]other’s relapse ‘undid’ all of her previous and
    subsequent attempts to substantially comply with the requirements of her permanency
    plans.”).
    Here, Mother’s behavior over the approximately two years leading to trial shows a
    general lack of effort on Mother’s part. DCS workers consistently testified that Mother
    was difficult to contact to provide assistance in working the plan. Mother repeatedly
    began programs or services, only to stop her involvement prior to completion. Although
    the permanency plan makes clear that Mother’s mental health and substance abuse were
    among the core issues in the permanency plan, Mother failed to make substantial effort to
    attend inpatient or outpatient treatment. Mother blamed this failure on medical problems,
    deaths in the family, miscommunication, and waiting lists. Mother admitted, however,
    that at a certain point, she stopped working with service providers and “didn’t really deal
    with it.” With regard to an inpatient drug and alcohol treatment program, Mother likewise
    testified that she “just really ha[s]n’t been thinking about it right here lately.” As such,
    Mother’s behavior over the course of the more than two years that DCS has most recently
    been involved with this case illustrates a pattern where Mother makes little to no effort to
    complete the requirements under the plan, always laying the blame elsewhere. Thus, this
    is simply not the case wherein a parent makes considerable effort to work a permanency
    plan, only to fail to meet the desired outcomes of the plan due to a relapse near to the
    time of trial. See In re Zane W., No. E2016-02224-COA-R3-PT, 
    2017 WL 2875924
    , at
    *12 (Tenn. Ct. App. July 6, 2017) (reversing the trial court’s finding with regard to
    substantial non-compliance with permanency plans, where mother made effort to
    complete the plan’s requirements for two years, including attending required therapy,
    only to relapse shortly before trial). The trial court’s finding that this ground had been
    proven by clear and convincing evidence is therefore affirmed.
    Persistence of Conditions
    The trial court also based the termination of Mother’s parental rights on
    persistence of conditions. Persistence of conditions requires the trial court to find, by
    clear and convincing evidence, that:
    The child has been removed from the home of the parent or
    guardian by order of a court for a period of six (6) months
    and:
    (A) The conditions that led to the child’s removal or other
    conditions that in all reasonable probability would cause the
    - 15 -
    child to be subjected to further abuse or neglect and that,
    therefore, prevent the child’s safe return to the care of the
    parent(s) or guardian(s), still persist;
    (B) There is little likelihood that these conditions will be
    remedied at any early date so that the child can be safely
    returned to the parent(s) or guardian(s) in the near future; and
    (C) 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 parent’s continued inability to provide fundamental care to a child, even if not
    willful, . . . constitutes a condition which prevents the safe return of the child to the
    parent’s care.” In re A.R., No. W2008-00558-COA-R3-PT, 
    2008 WL 4613576
    , at *20
    (Tenn. Ct. App. Oct. 13, 2008) (citing In re T.S. & M.S., No. M1999-01286-COA-R3-
    CV, 
    2000 WL 964775
    , at *7 (Tenn. Ct. App. July 13, 2000)). The failure to remedy the
    conditions which led to the removal need not be willful. In re T.S. & M.S., 
    2000 WL 964775
    , at *6 (citing State Dep’t of Human Servs. v. Smith, 
    785 S.W.2d 336
    , 338 (Tenn.
    1990)). “Where . . . efforts to provide help to improve the parenting ability, offered over a
    long period of time, have proved ineffective, the conclusion is 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.” 
    Id. The purpose
    behind the “persistence of conditions”
    ground for terminating parental rights 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.” In re A.R., No. W2008-00558-
    COA-R3-PT, 
    2008 WL 461675
    , 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)).
    Here, there is no dispute that the children were adjudicated dependent and
    neglected and had been removed from Mother’s home for six months prior to the filing of
    the termination petition. With regard to this ground, the trial court found that three
    conditions led to the removal of the child: (1) “unaddressed drug and alcohol issues”; (2)
    “unaddressed mental health issues”; and (3) a “home environment [that] remains
    inappropriate for children.” The trial court found that these conditions had not been
    remedied and were unlikely to be remedied in the near future so as to allow the return of
    the children to Mother. The record on appeal supports the trial court’s findings.
    Here, as discussed above, the permanency plan created by DCS and agreed to by
    Mother illustrates that mental health, drug, and environmental issues were central to
    Mother’s ability to be reunited with her children. Unfortunately, in the more than two
    years since DCS most recently became involved with the family, Mother has made little
    - 16 -
    to no progress toward meeting these goals. Mother testified at trial that her mental health
    has suffered due to recent family losses. While we are certainly sympathetic to the
    problems that Mother has faced, her children simply cannot return to her until she can
    demonstrate stability and a desire to make improvements. Rather than demonstrate
    improvement, however, Mother testified that she utilized illegal drugs to deal with the
    stress and grief caused by her family losses and that she has recently chosen not to “deal”
    with the service providers referred by DCS or to really contemplate seeking the intensive
    inpatient treatment that was recommended.
    In addition, while Mother testified that she was making improvements to her
    home, she admitted that even she was unable to live in the home full-time in the summer
    of 2016 because it lacked electricity. As of the date of trial, the home still had no working
    electricity. Moreover, Mother’s failure to maintain contact with DCS workers and make
    herself available for home visits means that DCS was unable to determine if Mother’s
    recent efforts have in fact improved the home. As late as September 2016, however, a
    DCS worker testified that the home was still cluttered and infested with bugs. Given that
    little to no improvements took place while DCS was able to make home visits, we are
    reluctant to credit Mother’s testimony that the home has now improved to a point that the
    children may safely return. Under these circumstances, it appears that the conditions that
    led to the children’s removal, specifically Mother’s unaddressed drug and mental health
    issues and the environmental concerns of her home, have not been sufficiently addressed,
    nor are they likely to be addressed, so as to allow reunification of the family at an early
    date. Moreover, although there has been some instability in the children’s placement
    previously, the record establishes that the children are now in a safe and stable home,
    placed with a family that wants to adopt the children. The children’s therapists both
    testified that stability is integral to the children’s progress. Mother’s unaddressed issues
    show that, while her love for the children has not waivered, she simply cannot provide
    the type of stability necessary for her children. Thus, maintaining the relationship with
    Mother “diminishes the child’s chances of early integration into a safe, stable and
    permanent home.” Tenn. Code Ann. § 36-1-113(g)(3). The trial court’s finding that clear
    and convincing evidence supports this ground for termination is therefore affirmed.
    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 child’s best interest. White v. Moody, 
    171 S.W.3d 187
    , 192
    (Tenn. Ct. App. 1994). When a parent has been found to be unfit (upon establishment of
    ground(s) for termination of parental rights), the interests of parent and child diverge. In
    re Audrey 
    S., 182 S.W.3d at 877
    . The focus shifts to the child’s best interest. 
    Id. Because not
    all parental conduct is irredeemable, Tennessee’s termination of parental
    rights statutes recognize the possibility that terminating an unfit parent’s parental rights is
    not always in the child’s best interest. 
    Id. However, when
    the interests of the parent and
    - 17 -
    the child conflict, courts are to resolve the conflict in favor of the rights and best interest
    of the child. Tenn. Code Ann. § 36-1-101(d). Further, “[t]he child’s best interest must be
    viewed from the child’s, rather than the parent’s, perspective.” 
    Moody, 171 S.W.3d at 194
    .
    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. 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 affect 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 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 or controlled substances 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; or
    (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).
    Depending on the circumstances of an individual case, the consideration of a single factor
    - 18 -
    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.
    In re Audrey S., 182 S .W.3d at 878 (citing White v. 
    Moody, 171 S.W.3d at 194
    ).
    The trial court made detailed findings of fact to support its determination that
    termination of Mother’s parental rights was in the children’s best interest, including
    discussion of the testimony provided by DCS regarding Mother’s progress and the
    testimony of the children’s therapists and foster mother regarding their progress since
    removal. Based upon these findings, the trial court made the following pronouncements:
    43. It is in the children’s best interests for termination to be granted as to
    [Mother], because she has not made changes in her conduct or
    circumstances that would make it safe for the children to go home. The
    Court finds that it is not safe for the children to return to [Mother] at this
    time. [Mother] has not completed the recommendations of her assessments.
    She has not completed alcohol and drug counseling. She has not
    participated in mental health counseling. Her home is not environmentally
    safe.
    44. It is in the children’s best interests for termination to be granted as to
    [Mother], because she has not made lasting changes in her lifestyle or
    conduct after reasonable efforts by the state to help, so that lasting change
    does not appear possible. The Court specifically finds that [DCS] has made
    reasonable efforts in this cause to assist [Mother] in addressing her
    substance abuse issues, mental health concerns, and housing issues, all to
    no avail.
    45. The Court finds that the children do have a meaningful relationship
    with [Mother].
    46. It is in the children’s best interests for termination to be granted as to
    [Mother], because changing caregivers at this stage of their lives will have a
    detrimental effect on them. The Court specifically finds that both of the
    children’s therapists testified that the children are in need of stability,
    consistency and permanency. This is important to their overall wellbeing.
    The Court further finds that the children have attained stability in the
    - 19 -
    [foster] home, in that, with the exception of a three (3) month period of
    time, they have lived in this home for the last two (2) years.
    47. It is in the children’s best interests for termination to be granted as to
    [Mother], because she has neglected the children and other children who
    are their siblings.
    48. It is in the children’s best interests for termination to be granted as to
    Respondent, because there is crime in her home. The Court specifically
    finds that [Mother] is abusing illegal drugs, raising concerns for the illegal
    activity that is ongoing in her home and life.
    49. [] The Court finds that it is in the children’s best interests for
    termination to be granted as to [Mother], because she abuses illegal drugs,
    rendering her consistently unable to care for the children [in a] safe and
    stable manner. [Mother] has continuously struggled with drug abuse during
    the pendency of the dependent and neglect proceedings over the past two
    (2) years. She has attempted multiple drug treatment programs and has
    never completed any of them. She acknowledged in her testimony that she
    needs drug treatment. She tested positive for illegal drugs on a drug screen
    by DCS as recently as December, 2016, and when asked by the [DCS]
    during her cross-examination if she would pass a drug screen today, she
    acknowledged that she did not know and that she had used illegal drugs as
    recently as three (3) weeks ago. She acknowledged that she uses illegal
    drugs when she is depressed or overwhelmed, although she denied the
    categorization of her drug use as “self-medicating.” The Court finds that
    [M]other’s continued drug use does render her consistently unable to care
    for the children in a safe and stable manner and this factor weighs in favor
    of termination of [Mother]’s parental rights.
    50. It is in the children’s best interests for termination to be granted as to
    [Mother] because her mental and emotional state would be detrimental to
    the children and would prevent her from effectively parenting the children.
    The Court finds that [Mother] needs to be stable to meet not only her needs
    but the needs of the children. Up to this point, she has not demonstrated that
    she is even able to meet her own mental health needs.
    51. It is in the children’s best interests for termination to be granted as to
    [Mother] because she has not paid child support consistently.
    52. It is in the children’s best interests for termination to be granted as to
    [Mother], because she has shown little or no interest in the welfare of the
    children. The Court finds that, as to [Mother], she appears to be content
    with having only supervised visitation with the children and making no
    further steps towards getting the children home. While this may be
    acceptable to her, it is not acceptable for the children.
    53. It is in the children’s best interests for termination to be granted as to
    [Mother], because the children have established a strong bond with their
    foster parents, who wish to adopt them.
    - 20 -
    The record on appeal generally supports the trial court’s findings with regard to
    the best interests of the children. As the trial court found, testimony from both Mother
    and a service provider who supervised visitation indicated that Mother and the children
    had a close and loving bond, which has been maintained through Mother’s largely
    consistent visitation. See Tenn. Code Ann. § 36-1-113(i)(3) & (4). As such, these factors
    do not militate in favor of termination. Although the trial court also found that Mother’s
    failure to pay child support favored termination, this factor is less certain, as the record is
    unclear as to Mother’s ability to pay support. See Tenn. Code Ann. § 36-1-113(i)(9).
    Other factors, however, strongly favor termination. Here, Mother has consistently
    admitted to abusing drugs to combat her mental health issues, rather than seeking and
    completing mental health treatment. See Tenn. Code Ann. § 36-1-113(i)(8). Because
    Mother has inconsistently sought appropriate treatment, it is not clear that Mother would
    maintain the mental health treatment that both of the children’s therapists testified was
    necessary to their continued progress. Changing caretakers therefore is likely to have
    detrimental effect on the children. See Tenn. Code Ann. § 36-1-113(i)(5).
    The home in which Mother lives is also not appropriate for the children to return.
    See Tenn. Code Ann. § 36-1-113(i)(7). When DCS workers were allowed in Mother’s
    home, they observed that it remained cluttered and bug-infested even years after the
    children were removed. Mother admitted at trial that the house lacked electricity, making
    her unable to stay in the home for a time. Clearly, Mother’s inability or refusal to
    maintain drug-free and to establish a suitable living space for the children illustrates her
    failure to make an adjustment of circumstances so as to make it safe for the children to
    return to her care. See Tenn. Code Ann. § 36-1-113(i)(1). Finally, although Mother
    testified that she was currently taking parenting classes in order to meet the requirements
    of the parenting plan, Mother’s effort in the week before trial simply does not show that
    she has made a lasting adjustment or that she is likely to do so. See Tenn. Code Ann. §
    36-1-113(i)(2). Indeed, even with the serious consequences of the termination of her
    relationship with her children on the horizon, Mother chose to use illegal drugs, thereby
    substantially decreasing the likelihood that they would be returned to her at an early date.
    Finally, although the children’s placement has previously been disrupted, the record
    shows that their current foster home provides the children with the best chance of
    establishing stability and maintaining their progress. Based upon the trial court’s detailed
    findings above, we agree that DCS established clear and convincing evidence that
    termination of Mother’s parental rights was in the children’s best interests.
    Conclusion
    The judgment of the Juvenile Court of Washington County terminating Mother’s
    parental rights to her two children is affirmed and this cause is remanded to the trial court
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    for further proceedings as are necessary and consistent with this Opinion. Costs of this
    appeal are taxed to Appellant Felicia A., for which execution may issue if necessary.
    _________________________________
    J. STEVEN STAFFORD, JUDGE
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