in the Interest of I.R.Z, a Child v. Texas Department of Family and Protective Services ( 2022 )


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  • Affirmed and Memorandum Opinion filed December 8, 2022.
    In The
    Fourteenth Court of Appeals
    NO. 14-22-00431-CV
    IN THE INTEREST OF I.R.Z, A CHILD
    On Appeal from the 313th District
    Court Harris County, Texas
    Trial Court Cause No. 2021-00864J
    MEMORANDUM OPINION
    Appellant D.P. (Mother) appeals the trial court’s final decree terminating her
    parental rights to I.R.Z (Isaac). The trial court terminated Mother’s parental rights
    under Sections 161.001(b)(1)(D), (E), (N), and (O) of the Family Code and
    concluded that termination was in the best interest of Isaac. See Tex. Fam. Code
    §§ 161.001(b)(1)(D), (E), (N), & (O); 161.001(b)(2). Mother challenges the trial
    court’s final decree, arguing the evidence is legally and factually insufficient to
    support the trial court’s findings.1 Mother also challenges whether the evidence
    established that she was unable to complete her services. We affirm.
    BACKGROUND
    Isaac was born to Mother and father in May 2021. While in the hospital for
    Isaac’s birth, both Mother and Isaac tested positive for cocaine and opiates. Mother
    also tested positive for benzos and marijuana at that time. Isaac was placed in the
    neonatal intensive care unit (NICU) for two weeks because he was exhibiting
    symptoms of withdrawal. Isaac was reportedly agitated, had a high heart rate, and
    was jittery. Mother and father visited Isaac while he was in the NICU.
    Upon discharge, from approximately June to November 2021, Isaac was
    placed with a foster family. Mother and father did not visit or attempt to visit Isaac
    during this time. In October 2021 through the time of trial, Mother was in jail
    awaiting trial. Mother has not seen Isaac since he was two weeks old. In November
    2021, Isaac’s paternal grandmother took Isaac into her care. Mother and father’s
    daughter is also in grandmother’s care. At the time of trial, Isaac was living with
    grandmother.
    At trial, an early childhood interventionist testified that she began working
    with Isaac when he was approximately one month old. At the time of trial in April
    2022, Isaac was about eleven months old. The interventionist testified that Isaac
    was developmentally delayed in his gross motor skills of crawling, rolling, and
    sitting. Isaac was also delayed in fine motor skills such as his ability to use his hands
    and fingers. The interventionist testified without objection that Isaac experienced
    substance exposure in utero and that he had spent time in the NICU before being
    1
    Father’s parental rights were also terminated but he does not appeal the trial court’s final
    decree.
    2
    discharged. The childhood interventionist testified that the potential cause of Isaac’s
    delays was the substance exposure, but she was not qualified to provide an opinion
    on the cause. Her recommendation was to refer Isaac to a neurologist to address the
    issues that she was seeing with Isaac’s development and to determine the root cause.
    The interventionist also testified that Isaac suffered from plagiocephaly and
    brachycephaly, and Isaac’s plagiocephaly was “severe.” The interventionist testified
    that Isaac’s grandmother has secured the necessary medical interventions to address
    the plagiocephaly. Grandmother is also working “diligently” on Isaac’s gross and
    fine motor skills and is following through with all the interventionist’s
    recommendations and strategies for Isaac.
    A conservatorship worker testified, without objection, that Isaac “came into
    care” because he and Mother tested positive at birth for cocaine and opiates. The
    worker testified that Mother tested positive for benzos and marijuana in addition to
    the opiates and cocaine. The worker also testified that Isaac exhibited symptoms of
    withdrawal and that he was placed in the NICU and given morphine to relieve his
    symptoms. She testified that Mother and father did not visit Isaac once he was
    discharged but that Mother did request photos of Isaac. Isaac has been with his
    grandmother since he was six-months old.
    The worker also testified that a parenting plan was created for Mother in late-
    May, early-June 2021. The worker attempted to engage Mother in services through
    calls and text messages, but most of the attempts went unanswered. The worker
    testified that she submitted referrals to Mother for services prior to Mother’s
    incarceration and Mother did not attend. The worker was not able to provide Mother
    with her plan until early 2022.       Mother’s plan involved parenting classes, a
    psychological examination, individual therapy, a substance abuse assessment, “case
    involvement,” stable housing, legal income, random drug screening, and narcotics
    3
    or alcoholics anonymous. All of these services were ordered by the trial court. and
    none were completed by Mother. The worker testified that she met with Mother in
    jail and reviewed the plan with Mother, but because she could not physically hand
    Mother the plan in the jail, the worker also emailed the plan to her. Mother did not
    indicate to the worker that Mother had any questions about the plan. The worker
    testified that Mother attempted to complete a parenting course while in jail but was
    discharged for non-compliance.       The worker testified that Mother could have
    completed some of the plan from jail and that there is a “kiosk” in the jail that Mother
    could have used to register for different services. The kiosk is where Mother would
    have registered for the parenting class she started while incarcerated. The worker
    testified that other than the parenting class and the psychological evaluation, she was
    not sure what other services Mother could complete from jail. The worker agreed
    that Mother did seem interested in Isaac and seeing her child but was unable to do
    so from jail.
    The worker testified that Mother’s other children did not reside with her and
    were in the care of others, but the worker was not sure about the legal status of those
    children and whether Mother’s parental rights had been terminated. The worker
    testified that Isaac and grandmother have bonded and that grandmother takes Isaac
    to all his appointments and provides for his needs. There are no concerns about
    Isaac’s placement with grandmother, and Isaac is well taken care of.
    Mother testified that at the time of trial she was incarcerated for an aggravated
    robbery with a deadly weapon charge. Her “understanding” of why Isaac came into
    the Department’s care was because Isaac and she were positive for cocaine and
    opiates. Mother testified that she took prenatal vitamins but did not have a medical
    provider during her pregnancy. Mother testified that she visited Isaac while he was
    in the NICU but not at all once he was in foster care. The last time she saw Isaac
    4
    was when he was two weeks old. Mother testified that the caseworker reached out
    and attempted to engage Mother in both visits and services, that she did not engage
    in services, and that she tried to visit Isaac. Mother also testified that she did not
    submit to any drug testing. Mother further testified that Isaac is well cared for by
    his grandmother and all of his needs are being met. Prior to Isaac’s birth, Mother
    testified that she stayed in hotels and had completed a jail sentence, gotten “clean,”
    and, once home, relapsed.
    Mother testified that during her current incarceration she had completed
    “about a month and a half” of a ninety-day program called “Mentoring Moms.”
    Mother was participating in “AA” but there were no other services she could
    complete while in jail. Mother testified that she did not know whether she could or
    needed to complete a psychiatric evaluation from jail. Mother did not believe that
    terminating her rights was in Isaac’s best interest because she wanted “to do anything
    possible to be part of his life and not have [her] parental rights revoked because [she
    is] willing to do whatever it takes . . . to be his parent.” Mother’s testified her
    incarceration meant she did not “have the option” to do what she needed to do to get
    Isaac back. Mother stated that her plan is to obtain employment and stable housing
    and to be part of Isaac’s life once released.
    When asked whether she had used any substances during her pregnancy with
    Isaac while she knew she was pregnant, Mother invoked her Fifth Amendment right
    and refused to answer.      When asked whether she used any illegal drugs while
    pregnant with Isaac, Mother invoked her Fifth Amendment right and refused to
    answer. When asked whether Mother has “a criminal history” in the state of New
    Jersey, Mother invoked her Fifth Amendment right and refused to answer.
    5
    Father testified that Isaac came into care due to “substance abuse issues” but
    asserted his Fifth Amendment right when questioned directly about Mother’s
    substance abuse while pregnant.
    An advocacy supervisor testified that termination is in the best interest of Isaac
    because of Isaac’s age and vulnerability due to his “extensive and immediate care
    needs” that are unable to be met by his parents. The supervisor also testified that
    grandmother has shown she can provide for these needs.                 She testified that
    grandmother’s home is safe, Isaac has his own room, and his basic needs are being
    met. The supervisor testified that Mother has not provided any kind of assistance to
    Isaac.
    Grandmother testified that Isaac had been in her care for five months at the
    time of trial. Grandmother is Isaac’s paternal grandmother and also is the caregiver
    of Isaac’s older sister. The older sister is also a child of Mother and father and
    subject to a prior family case in New Jersey. Grandmother testified that Isaac had
    bonded with her, his older sister, and grandmother’s life partner. Grandmother stays
    home with the children and takes Isaac to all of his medical appointments.
    Grandmother testified that she is willing to adopt Isaac and that her life partner is
    agreeable to that. Grandmother indicated that she had the financial means to take
    care of Isaac.
    PREDICATE GROUND FOR TERMINATION
    In four issues, Mother argues that the evidence is legally and factually
    insufficient to support termination of her parental rights under Section
    161.001(b)(1)(D), (E), (N) and (O).
    6
    A.    General Legal Principles
    Parents’ rights to raise and nurture their children are protected by the United
    States Constitution and the Texas Constitution. In re J.F.-G., 
    627 S.W.3d 304
    , 311
    (Tex. 2021). To deny a parent these rights, the State must establish by clear and
    convincing evidence both a legal ground to terminate the parent’s right and that the
    termination is in the best interest of the child. Id.; see also Tex. Fam. Code
    § 161.001.
    While this high evidentiary burden requires a heightened standard of review
    on appeal, it does not dispel the deference that an appellate court must grant to the
    fact finder. In re J.F.-G., 627 S.W.3d at 311–12. This review “take[s] into
    consideration whether the evidence is such that a fact finder could reasonably form
    a firm belief or conviction about the truth of the matter on which the State bears the
    burden of proof.” In re J.F.C., 
    96 S.W.3d 256
    , 266 (Tex. 2002). Even in parental
    termination cases, the appellate court must defer to the trial court’s factual
    determinations because the fact finder is the sole arbiter of the witnesses’ credibility
    and demeanor. In re J.F.-G., 627 S.W.3d at 312. We assume the fact finder resolved
    conflicting evidence in favor of its finding if a reasonable fact finder could do so.
    Id. We disregard all evidence that a reasonable fact finder could have disbelieved.
    Id.
    “Evidence is legally sufficient if, viewing all the evidence in the light most
    favorable to the fact-finding and considering undisputed contrary evidence, a
    reasonable factfinder could form a firm belief or conviction that the finding was
    true.” In re A.C., 
    560 S.W.3d 634
    , 631 (Tex. 2018). “Factual sufficiency . . . requires
    weighing disputed evidence contrary to the finding against all the evidence favoring
    the finding.” 
    Id.
     The court must consider whether disputed evidence “is such that a
    reasonable factfinder could not have resolved it in favor of the finding.” 
    Id.
    7
    To terminate a parent’s legal rights to a child, Section 161.001 of the Family
    Code requires two findings: (1) the parent’s acts or omissions must satisfy an
    enumerated statutory ground for termination; and (2) termination must be in the
    child’s best interest. See Tex. Fam. Code §161.001; see also In re J.F.-G., 627
    S.W.3d at 312. There are twenty-one possible grounds for termination. See Tex.
    Fam. Code § 161.001(b)(1). Only one predicate finding under Section 161.001(b)
    is necessary to support a final order of termination when there is also a finding that
    termination is in the best interest of the child. See In re A.V., 
    113 S.W.3d 355
    , 362
    (Tex. 2003); In re F.M.E.A.F., 
    572 S.W.3d 716
    , 736 (Tex. App.—Houston [14th
    Dist.] 2019, pet. denied). If we conclude that there is sufficient evidence to support
    one of the predicate findings, generally we need not address the other predicate
    findings. In re F.M.E.A.F., 572 S.W.3d at 736. However, because termination under
    Section 161.001(b)(1)(D) or (E) may have implications for a parent’s rights to other
    children, we must independently address issues challenging a trial court’s findings
    under those subsections. In re N.G., 
    577 S.W.3d 230
    , 237 (Tex. 2019). Accordingly,
    we first consider Mother’s sufficiency challenge to the trial court’s findings
    regarding subsections (D) and (E), and only if such findings cannot be sustained, we
    will consider whether statutory grounds for termination exist under subsections (N)
    and (O). See generally Tex. R. App. P. 47.1.
    Under subsection (D), the endangerment analysis focuses on the evidence of
    the child’s physical environment, although the environment produced by the conduct
    of the parents bears on the determination of whether the child’s surroundings
    threaten his well-being. In re D.M.K., No. 14-13-00230-CV, 
    2013 WL 5347392
    , at
    *10 (Tex. App.—Houston [14th Dist.] Aug. 27, 2013, no pet.) (mem. op.). Under
    subsection (D), we examine the evidence related to the environment of the children
    to determine whether the environment was the source of endangerment to the
    8
    children’s physical or emotional well-being. In re K.A.S., J.G.S., and W.S., II, 
    131 S.W.3d 215
    , 222 (Tex. App.—Fort Worth 2004, pet. denied).
    Under subsection (E), a court may order termination of the parent-child
    relationship if the court finds by clear and convincing evidence that the parent
    engaged in conduct which endangers the physical or emotional well-being of the
    child. Tex. Fam Code § 161.001(b)(1)(E). The term “endanger” means the child
    was exposed to loss or injury or jeopardized. In re C.A.B., 
    289 S.W.3d 874
    , 882
    (Tex. App.—Houston [14th Dist.] 2009, no pet.) (citing Tex. Dep’t of Human Servs.
    v. Boyd, 
    727 S.W.2d 531
    , 533 (Tex. 1987)). Endangerment encompasses more than
    a threat of metaphysical injury or possible ill effects of a less-than-ideal
    environment. 
    Id.
     (citing Boyd, 727 S.W.2d at 533). The statute does not require that
    conduct be directed at a child or cause actual harm; rather, it is sufficient if the
    conduct endangers the emotional well-being of the child. In re J.F.-G., 627 S.W.3d
    at 312. Termination under subsection (E) must be based on more than a single act
    or omission; the evidence must demonstrate a voluntary, deliberate, and conscious
    course of conduct by the parent. In re E.R.W., 
    528 S.W.3d 251
    , 264 (Tex. App.—
    Houston [14th Dist.] 2017, no pet.).
    B.    Analysis
    Mother argues that there is legally and factually insufficient evidence to
    support termination under subsection (D) because under this subsection the trial
    court must examine the conditions prior to the child’s removal. Mother argues that
    because the child was removed from her care at birth, the State cannot establish this
    ground because she never had the child in her custody and could not have
    endangered him before he was born. Mother argues that because both parents have
    had only hospital visits with Isaac and had no say regarding his living conditions,
    this predicate ground for termination was not met. Mother also argues that there is
    9
    legally and factually insufficient evidence to support termination under subsection
    (E) because the State failed “to prove that Mother engaged in any conduct that
    harmed the child.” Mother argues that the evidence pertaining to her substance
    abuse while she was pregnant is “non-existent.”
    At trial, Mother testified and admitted that she was “aware” Isaac came into
    the Department’s care because she and Isaac tested positive for cocaine and opiates.
    Mother did not deny the use of illegal drugs while pregnant and instead invoked the
    Fifth Amendment. Other witnesses also similarly testified, without objection, that
    Isaac and Mother both tested positive for drugs at the time of Isaac’s birth. Exhibit
    18 indicates that Isaac was “born positive for multiple drugs and was diagnosed with
    Neonatal Abstinence Syndrome by a physician after birth. He was hospitalized for
    two weeks after birth and placed on morphine to ween him off the drugs.” Multiple
    witnesses testified, without objection, to Isaac’s stay in the NICU immediately after
    his birth because of his positive drug test and his drug exposure. Viewing this
    evidence in the light most favorable to the judgment, this evidence supports the trial
    court’s finding of endangerment. See In re M.J., No. 14-20-00449-CV, 
    2020 WL 7038526
    , at *6 (Tex. App.—Houston [14th Dist.] Dec. 1, 2020, no pet.) (mem. op.)
    (“[A] mother’s drug abuse during pregnancy is particularly endangering to an
    unborn child’s physical well-being.”); In re K.C.B., 
    280 S.W.3d 888
    , 895 (Tex.
    App.—Amarillo 2009, pet. denied) (“A mother’s use of drugs during pregnancy may
    be conduct which endangers the physical and emotional well being of the child.”);
    see also In re A.J.F., No. 07-20-00242-CV, 
    2021 WL 423442
    , at *3 (Tex. App.—
    Amarillo 2021, no pet.) (mem. op.) (“At birth, A.J.F. tested positive for the presence
    of illegal drugs, supporting an inference that S.G.'s drug use created conditions or
    surroundings that exposed A.J.F. to the substances while in utero.”); In re K.A.B.M.,
    10
    
    551 S.W.3d 275
    , 287 (Tex. App.—El Paso 2018, no pet.) (“A parent’s use of drugs
    may qualify as an endangering course of conduct.”).
    Both Mother and father invoked their Fifth Amendment right against self-
    incrimination when asked about Mother’s drug use during her pregnancy with Isaac.
    The trial court is permitted to make a negative inference based upon the assertion of
    the privilege. See In re J.J., No. 14-19-00622-CV, 
    2020 WL 428859
    , at *6 (Tex.
    App.—Houston [14th Dist.] Jan. 28, 2020, pet. denied) (mem. op.) (“Mother
    declined to testify about these charges by asserting her Fifth Amendment right
    against self-incrimination, permitting the trial court to draw an adverse inference
    concerning the charges.”); V.C. v. Tex. Dep’t of Fam. & Protective Servs., No. 03-
    18-00746-CV, 
    2019 WL 1388725
    , at *2 (Tex. App.—Austin Mar. 28, 2019, pet.
    denied) (mem. op.) (“Although a witness may assert her Fifth Amendment right
    against self-incrimination in a civil trial if she is asked a question that might tend to
    subject her to criminal responsibility, the jury may make negative inferences based
    upon the assertion of the privilege.”).2
    While Mother argues that she was not provided with enough time to complete
    her services and plan, Mother also admitted that she chose not to engage in her
    services for a period of four months prior to her incarceration. The worker testified
    that she called and texted Mother about her plan and completing services under the
    plan. Mother agreed that the worker contacted her about completing services and
    Mother did not engage in those services under the plan. Mother also testified that
    she enrolled in a parenting course but failed to complete the course. The worker
    testified that Mother was discharged from the course for non-compliance. While the
    2
    “The State may not, however, obtain ‘an adverse judgment against a party to a civil
    proceeding solely because that party refuses to testify on the basis of the privilege against self-
    incrimination.’” V.C., 
    2019 WL 1388725
    , at *2 n.3 (quoting In re Verbois, 
    10 S.W.3d 825
    , 829
    (Tex. App.—Waco 2000, orig. proceeding)).
    11
    evidence demonstrated Mother had limited options for completing her service plan
    while incarcerated, Mother failed to demonstrate that she was committed to
    completing those services available to her while in jail.           Mother’s prior
    unwillingness to engage in services, Mother’s discharge from the parenting course
    for non-compliance while in jail, and Mother’s failure to complete any services
    available to her supports the trial court’s endangerment finding. See In re M.R., 
    243 S.W.3d 807
    , 819 (Tex. App.—Fort Worth 2007, no pet.) (upholding termination
    under subsections (D) and (E) because the evidence showed that the mother exposed
    her children to domestic violence, placed them in an environment of drug abuse, and
    refused to participate in her CPS service plan).
    The evidence also demonstrated that while Mother was not incarcerated, she
    did not attempt to see Isaac. While Mother requested photos of Isaac, Mother did
    not attempt to set up any visits with him. Further, there was evidence that prior to
    incarceration, Mother’s housing was unstable and that she was staying in hotels.
    Mother also testified regarding a prior incarceration wherein she “got clean,” but,
    once home, she relapsed. Mother also invoked her Fifth Amendment right when
    asked about her prior criminal behavior in New Jersey.
    Mother argues that her drug use was only “alleged” and not proven because
    there were no drug test results, medical records, or testimony from persons with
    knowledge. Much of the testimony regarding Mother and Isaac’s drug test results
    was not objected to. There were no objections to the witness testimony or the
    admitted exhibits that demonstrated Mother’s illegal drug use while pregnant with
    Isaac. Mother did not take any witnesses on voir dire to examine the basis for their
    testimony to determine whether the witness had personal knowledge. The only
    objections made were to exhibits 15 and 17 on the basis of relevance, as well as to
    12
    exhibits 17 and 18 on the basis of hearsay. All of these objections were overruled
    by the trial court.
    On appeal, Mother argues that exhibit 19 is “clearly unverified hearsay” and
    should be excluded from the record. However, no objection was lodged to exhibit
    19 at trial. Therefore, Mother has failed to preserve any argument regarding exhibit
    19. See Tex. R. App. P. 33.1(a); Austin v. Weems, 
    337 S.W.3d 415
    , 421 (Tex.
    App.—Houston [1st Dist.] 2011, no pet.). Mother also asserts that we should
    discount the testimony from the interventionist regarding Isaac’s positive drug test
    at birth because there was a hearsay objection the trial court should have sustained.
    However, even if we were to agree with Mother that the trial court should have
    sustained this objection, there were no objections to the other evidence concerning
    Isaac’s positive drug test at the time of his birth. Thus, even disregarding this one
    response from the interventionist, there is sufficient evidence that the trial court
    could have relied upon to support the conclusion that Mother exposed Isaac to illegal
    drugs while she was pregnant and that such drug use caused Isaac physical harm
    resulting in two weeks of treatment in the NICU.
    Considering all the evidence in the light most favorable to the trial court’s
    finding, we conclude a reasonable fact finder could form a firm belief or conviction
    that Mother knowingly placed the child in conditions which endangered his physical
    or emotional well-being and engaged in conduct which endangered the physical or
    emotional well-being of the child. See In re A.C., 560 S.W.3d at 631. Considering
    the disputed evidence contrary to the findings against all of the evidence favoring
    the findings, we conclude that a reasonable fact finder could have resolved this
    evidence in favor of the above findings. See id. Therefore, we conclude that the
    evidence is legally and factually sufficient to support the trial court’s findings under
    subsections (D) and (E). See In re J.T.G., 
    121 S.W.3d 117
    , 125–28 (Tex. App.—
    13
    Fort Worth 2003, no pet.) (considering evidence of children’s health complications
    caused by mother’s drug use during pregnancy as conditions or surroundings that
    endangered the well-being of the children under (D) and (E)); In re A.J.F., 
    2021 WL 423442
    , at *3 (concluding evidence was legally and factually sufficient to support
    subsection (D) finding where mother admitted to drug use while pregnant and baby
    tested positive for drugs at birth); In re B.R., No. 02-11-00146-CV, 
    2011 WL 5515502
    , at *4 (Tex. App.—Fort Worth Nov. 10, 2011, no pet.) (mem. op.) (holding
    that evidence of mother’s heroin use throughout pregnancy permitted fact finder to
    reasonably conclude mother “knowingly placed or knowingly allowed [child] to
    remain in conditions or surroundings that endangered his physical well-being while
    in the womb”); see also In re J.E., No. 14-16-00850-CV, 
    2017 WL 1274081
    , at *5
    (Tex. App.—Houston [14th Dist.] April 4, 2017, pet. denied) (mem. op.) (“A
    mother’s drug use during pregnancy may amount to conduct that endangers the
    physical and emotional well-being of the child.”).
    Concluding that the evidence is legally and factually sufficient to support
    termination of Mother’s parental rights under subsection (D) or (E), we overrule
    Mother’s first and second issues. Because we conclude there is sufficient evidence
    to support one of the predicate findings, we need not address Mother’s issues three,
    four, or five. See In re F.M.E.A.F., 572 S.W.3d at 736; Tex. R. App. P. 47.1.
    BEST INTEREST OF THE CHILD
    In her final issue, Mother contends that the evidence is legally and factually
    insufficient to support the trial court’s conclusion that termination of her parental
    rights is in Isaac’s best interest.
    14
    A.    General Legal Principles
    There is a strong presumption that the best interest of a child is served by
    preserving the parent-child relationship. In re F.M.E.A.F., 572 S.W.3d at 726. In
    assessing whether the evidence is sufficient to prove that termination is in the best
    interest of a child, we may consider the non-excusive factors discussed in Holley v.
    Adams, 
    544 S.W.2d 367
    , 371–72 (Tex. 1976). The factors include: (1) the child’s
    desires; (2) the child’s present and future emotional and physical needs; (3) any
    present or future emotional and physical danger to the child; (4) the parental abilities
    of the individuals seeking custody; (5) the programs available to assist the
    individuals seeking custody to promote the child’s best interest; (6) the plans for the
    child by the individuals or agency seeking custody; (7) the stability of the home or
    proposed placement; (8) the parent’s acts or omissions which may indicate that the
    existing parent-child relationship is improper; and (9) any excuse for the parent’s
    acts or omissions. See F.M.E.A.F., 572 S.W.3d at 726 (citing Holley, 54 S.W.2d at
    371–72). We also consider the statutory factors in Section 263.307 of the Family
    Code, including the child’s age and vulnerabilities. See id. The best-interest analysis
    is child-centered and focuses on the child’s well-being, safety, and development. Id.
    “[A] parent’s use of narcotics and its effect on his or her ability to parent may qualify
    as an endangering course of conduct.” In re J.O.A., 
    283 S.W.3d 336
    , 345 (Tex.
    2009).
    Clear and convincing evidence is the measure or degree of proof that will
    produce in the mind of the trier of fact a firm belief or conviction as to the truth of
    the allegations sought to be established. Tex. Fam. Code § 101.007. This heightened
    burden of proof results in a heightened standard of review when evaluating the
    sufficiency of the evidence. In re L.G.R., 498 S.W.3d at 202.
    15
    In a legal sufficiency review, we look at all the evidence in the light most
    favorable to the finding to determine whether a reasonable fact finder could have
    formed a firm belief or conviction that the finding was true. In re J.F.C., 96 S.W.3d
    at 266. We assume the fact finder resolved disputed facts in favor of its finding if a
    reasonable fact finder could do so. Id. We disregard all evidence that a reasonable
    fact finder could have disbelieved or found to have been incredible, but we do not
    disregard undisputed facts. Id.
    In a factual sufficiency review, we also consider disputed and conflicting
    evidence. See In re J.O.A., 
    283 S.W.3d 336
    , 345 (Tex. 2009); see also In re A.C.,
    560 S.W.3d at 630–31. “If, in light of the entire record, the disputed evidence that
    a reasonable fact finder could not have credited in favor of the finding is so
    significant that a fact finder could not reasonably have formed a firm belief or
    conviction, then the evidence is factually insufficient.” In re J.F.C., 96 S.W.3d at
    266.
    B.     Analysis
    We review the Holley factors in considering whether the evidence is legally
    and factually sufficient to support the trial court’s finding that terminating Mother’s
    parental rights is in Isaac’s best interest.
    (1) The child’s desires
    At the time of trial, Isaac was about eleven months old and could not voice
    his desires. See In re A.C., 
    394 S.W.3d 633
    , 643 (Tex. App.—Houston [1st Dist.]
    2012, no pet.) (“The young age of the child rendered consideration of the child’s
    desires neutral.”). There was evidence of the bond between Isaac and grandmother.
    Grandmother testified that Isaac had bonded with her and the rest of the household
    and his needs are being met. The evidence also demonstrated that Mother had not
    16
    visited Isaac since he was two weeks old. Even discounting the time that Mother
    was incarcerated, Mother did not visit Isaac for a period of four months. See In re
    S.R., 
    452 S.W.3d 351
    , 369 (Tex. App.—Houston [14th Dist.] 2014, pet. denied)
    (“When children are too young to express their desires, the fact finder may consider
    whether the children have bonded with the foster family, are well-cared for by them,
    and have spent minimal time with a parent.”).
    (2) The child’s present and future emotional and physical needs
    The evidence demonstrated that Isaac was in occupational therapy twice per
    month and visited with the interventionist at least once per month.                The
    interventionist further recommended that Isaac see a neurologist to determine
    whether he had further medical issues. The evidence also showed that Isaac was
    developmentally delayed and needed additional help and support to meet his
    milestones. Grandmother testified that she takes Isaac to all of his appointments and
    is helping him to meet his milestones.
    An advocacy supervisor testified that termination is in the best interest of Isaac
    because of Isaac’s age and vulnerability due to his “extensive and immediate care
    needs” that are unable to be met by his parents. The evidence showed that Mother
    is not involved in caring for her other children, one of whom is already residing with
    grandmother. Grandmother has shown that she can provide for Isaac’s needs. The
    supervisor testified that grandmother’s home is safe, Isaac has his own room, and
    his basic needs are being met. Mother testified that it was her desire to obtain stable
    housing and employment once released but did not elaborate on any plans to do so.
    “Regarding this factor, we note that the need for permanence is a paramount
    consideration for the child’s present and future physical and emotional needs.” In
    re D.R.A., 
    374 S.W.3d 528
    , 533 (Tex. App.—Houston [14th Dist.] 2012, no pet.).
    17
    Establishing a stable, permanent home for a child is a compelling government
    interest. 
    Id.
    (3) Any present or future emotional and physical danger to the child
    At the time of trial, Mother was still incarcerated awaiting trial. Evidence
    regarding endangerment in support of the trial court’s finding under Section
    161.001(1) is also probative of a finding as to danger in determining the child’s best
    interest. See Walker v. Tex. Dept. of Fam. & Protective Servs., 
    312 S.W.3d 608
    ,
    617, 619 (Tex. App.—Houston [1st Dist.] 2009, pet. denied) (considering past drug
    use by parent as indicative of whether the child may be endangered in the future
    because of “the possibility that the parent may be impaired or imprisoned”); see also
    In re C.H., 
    89 S.W.3d 17
    , 28 (Tex. 2002). The evidence also showed that Isaac is
    very young and still vulnerable. Isaac has health issues and needs constant care and
    supervision. The evidence showed that Mother was not engaged in her service plan,
    demonstrating a lack of concern for changing her behavior and attending to Isaac’s
    needs.
    (4) Parental abilities of the individuals seeking custody
    Grandmother testified that Isaac had been in her care for five months at the
    time of trial. Grandmother is Isaac’s paternal grandmother and also is the caregiver
    of Isaac’s older sister. The older sister is also a child of Mother and father and
    subject to a prior family case in New Jersey, though parental rights were not
    terminated in that case. Grandmother testified that Isaac had bonded with her, his
    older sister, and grandmother’s life partner. Grandmother stays home with the
    children and takes Isaac to his appointments. Grandmother testified that she is
    willing to adopt Isaac and that her life partner is agreeable to that. Grandmother
    indicated that she had the financial means to take care of Isaac. Grandmother further
    18
    testified that she would be protective of Isaac and would determine whether it was
    in his best interest to have contact with his Mother and father.
    The advocacy supervisor testified that grandmother has shown that she can
    provide for Isaac’s needs. She testified that grandmother’s home is safe, Isaac has
    his own room, and his basic needs are being met.
    The evidence showed that Mother is not involved in parenting her other two
    children. See Walker, 
    312 S.W.3d at 617
     (“Evidence as to how a parent has treated
    another child or spouse is relevant regarding whether a course of conduct . . . has
    been established.”).    Mother did not complete the parenting course and was
    discharged for non-compliance. Mother did not seek prenatal care and continued to
    use illegal drugs while pregnant. Mother did not engage in completing her plan or
    the services she was referred to by the Department. See In re D.R.A., 374 S.W.3d at
    534 (considering that father did not complete “significant” aspects of his service plan
    and only sporadically visited his child as evidence demonstrating a lack of parental
    ability).
    (5) Programs available to assist those seeking custody to promote the
    child’s best interest
    Mother was offered various services through the Department and chose not to
    engage. See Walker, 
    312 S.W.3d at 620
     (considering whether parent had engaged
    in service plan). Grandmother takes Isaac to his appointments and follows through
    with the recommendations of those providers. Grandmother and the advocacy
    supervisor testified that grandmother works with Isaac at home and is helping him
    to progress and meet his milestones.
    19
    (6) Plans for the child by the individuals or agency seeking custody
    Grandmother testified that she is interested in adopting Isaac and her life
    partner was agreeable to the adoption. Grandmother further indicated that she
    wanted to be the one to make the decisions about what is best for Isaac, as opposed
    to his parents or anyone else. Grandmother intends to raise Isaac and his older sister
    together in her home.
    (7) Stability of the home or proposed placement
    At the time of trial, Mother was incarcerated and did not have a plan for
    housing or employment once she was released. Mother planned to obtain both
    housing and legal income upon her release but did not detail how she would do either
    in her testimony. Mother testified that prior to her incarceration she lived in various
    hotels and did not have stable housing.
    The advocacy supervisor testified that the Department had completed a home
    study of grandmother’s home and found it suitable for Isaac and approved his
    placement there. Grandmother testified that she stays home with the children and
    has income to support them.
    (8) Parent’s acts or omissions which may indicate that the existing parent-
    child relationship is improper
    Mother’s drug use during pregnancy and failure to obtain any prenatal care
    indicate an improper relationship and unwillingness to protect and care for Isaac.
    Mother’s further failure to engage in services to regain custody over Isaac further
    support this conclusion.
    (9) Any excuse for the parent’s acts or omissions
    No excuses were given for Mother’s failures to engage in services prior to
    incarceration. Mother argues that she was not given enough time to complete her
    20
    service plan once it was given to her. Mother further argues that she did not
    understand all aspects of her plan—specifically whether she needed to obtain a
    psychological assessment. However, Mother’s conduct of not engaging in services
    prior to her incarceration, not being involved in the lives of her other children, not
    visiting Isaac, and failing to engage in services at the time of trial support a
    conclusion that Mother was not willing to engage in any services to regain custody
    of Isaac.
    While not all factors have substantial evidence supporting termination, a
    majority of the factors weigh in favor of termination. Viewing the evidence in the
    light most favorable to the judgment, we conclude that the evidence is legally
    sufficient to support the trial court’s conclusion that termination of Mother’s parental
    rights is in Isaac’s best interest. Viewing all of the evidence equally, we conclude
    that a reasonable fact finder could have formed a firm belief or conviction that
    terminating Mother’s parental rights is in Isaac’s best interest.
    We overrule Mother’s final issue.
    CONCLUSION
    Concluding there is legally and factually sufficient evidence to support the
    trial court’s termination of Mother’s parental rights, we affirm the trial court’s final
    decree.
    /s/    Ken Wise
    Justice
    Panel consists of Chief Justice Christopher and Justices Wise and Hassan.
    21