GM v. The Children’s Aid Society of the Regional Municipality of Waterloo, 2025 CFSRB 37

CHILD AND FAMILY SERVICES REVIEW BOARD

BETWEEN:

GM Applicant

-and-

The Children’s Aid Society of the Regional Municipality of Waterloo Respondent

DECISION

Adjudicator: Donna A. Wowk

Date: March 21, 2025

Citation: 2025 CFSRB 37

Indexed As: GM v The Children’s Aid Society of the Regional Municipality of Waterloo (CYFSA s.120)

APPEARANCES

GM, Applicant Self-represented

The Children’s Aid Society of the Regional Municipality of Waterloo, Respondent Ben McIver, Counsel

INTRODUCTION

1This is an Application filed with the Child and Family Services Review Board (“CFSRB”) under section 120 of the Child, Youth and Family Services Act, 2017, S.O. 2017, c.14, Sched. 1 (“the Act”).

2The CFSRB found the Application eligible to proceed under subsections 120(4)4 and 120(4)5 of the Act.

3The Applicant is the mother of one child, EM (“the Child”). The Respondent had intermittent involvement with the Applicant and the Child between 2015 and May 26, 2024, the date of the Application.

4The Child is extremely high needs due to multiple and complex medical diagnosis. She requires specialized care and services.

5The Child has been in the temporary care and custody of the Respondent since April 2023 by way of court orders. Prior to April 2023, the Child was in the custody of the Applicant.

ISSUES

6The following are the allegations and issues for hearing as confirmed in the Interim Decision of the CFSRB dated July 29, 2024:

The Applicant alleges that:

1. She does not have clear information regarding the Child’s recent move, the reasons for that move, and what steps the Respondent took to challenge the move

2. She does not have clarity regarding the care and services the Child is receiving

3. She has not been provided with explanations for the Child’s rapid health deterioration in 2023, if available

4. She has not been given reasons for the Respondent’s refusal to engage in Alternative Dispute Resolution (“ADR”).

5. She has not been given reasons for the Respondent’s refusal to convene a Signs of Safety and/or Family Group Decision meeting

RESULT

7With respect to the issues as set out in paragraph 4 of this Decision, having considered the testimony, the documentary evidence and, the parties’ written submissions, I make the following findings:

a. Issue 1: I find the Respondent did not move the Child and is therefore not required to provide reasons for a move that did not take place.

The Child’s residential placement provider sent a notice of discharge to the Respondent. The Respondent took steps to preserve the Child’s placement. I find the Respondent provided the Applicant with reasons the residential placement provider had given the Respondent for the notice of discharge.

b. Issue 2: I find the Applicant was heard by the Respondent with respect to her concerns about being unable to be more involved in decisions regarding the Child’s care and services and that, in response, the Respondent implemented numerous measures to involve the Applicant and keep her informed of the Child’s care, health and treatment.

c. Issue 3: I find that the Applicant’s question regarding the Child’s rapid health deterioration in 2023 is medical in nature. I find that the Respondent heard the Applicant’s concerns. It provided her with the observations of the staff at the residential placement centre regarding their reported observations that resulted in the Child being taken to hospital. It also provided her with full access to the Child’s medical team during the Child’s 2023 hospitalization. The medical team were the persons with the expertise required to answer the Applicant’s questions.

d. Issue 4: I find that, as of the date of the Application, the Respondent had not provided the Applicant with reasons for not engaging in Alternative Dispute Resolution. I find that during the course of this proceeding the Respondent provided the Applicant with these reasons and that the parties have since engaged in mediation which appears to be ongoing.

e. Issue 5: I find that, as of the date of the Application, the Respondent had not responded to the Applicant in relation to Signs of Safety but that it did do so during the course of this proceeding.

I find that the Respondent has not provided the Applicant with reasons for not convening a Family Group Decision conference.

ANALYSIS

Issue 1: Did the Respondent provide the Applicant with reasons for the Child’s recent move and for its response to the move?

8The Child has not had a recent move. She has been in her current placement with DH, a residential program for children with complex needs, since April of 2023.

9The Child has complex medical needs and requires specialized care and treatment. She has resided in residential facilities since approximately 2016. In April 2024, DH issued a notice of its intent to discharge the Child in 60 days, however, it subsequently agreed that the Child could remain in its facility until a suitable placement could be found. The Child remains at DH.

10The Applicant testified that she asked Eileen Radford, a child protection worker employed by the Respondent, and Leslie Dottori, a child protection supervisor employed by the Respondent, to provide her with reasons for the Child’s move from DH. The Applicant’s testimony is that the Respondent advised her that it did not know the reasons for the move. However, in her January 16, 2025 signed witness statement, the Applicant states that the Respondent advised her on April 15, 2024 that DH felt their organization was at great risk because of “some different advocacy things” the Applicant had done.

11The Applicant submits that no reasons have been provided by the Respondent for its decision in relation to the Child’s ‘eviction’ from DH. However, it is clear on the evidence that the potential discharge of the Child from DH was a decision made by DH and not by the Respondent.

12Ms. Dottori’s affidavit evidence was that DH provided reasons for discharging the Child and that these reasons related to the actions and conduct of the Applicant and her advocates, including a publication of a blog by one of her advocates in which DH and the Child, while not named, were identifiable and which had been read by other parents of children at DH. Ms. Dottori informed the Applicant of the notice the Respondent had received from DH regarding the need to move the Child’s placement in 60 days, and requested a meeting with the Applicant to discuss the situation.

13Ms. Dottori testified that she and Ms. Radford met with the Applicant, Applicant’s legal counsel, and two individuals who provide support to the Applicant, one week after receiving the discharge notice. Ms. Dottori advised the Applicant, and those accompanying her, of the reasons provided by DH for it requiring the Child’s discharge, and invited those present to ask questions and provide input. The Applicant does not deny that this meeting took place nor does she deny that she, and those with her, were permitted to ask questions and provide their input. Despite this, she maintained that she was not provided with reasons for discharge notice. None of the others present with the Applicant gave evidence at the hearing.

14Ms. Dottori’s evidence was that the concerns raised by DH had been raised by other service providers, including by DH prior to the discharge notice, and that she had attempted to address these issues with the Applicant on many occasions. The Applicant was aware of the concerns of services providers involved with the Child about her conduct and about those advocating on her behalf, as these concerns had been discussed with the Applicant on numerous occasions by Ms. Dottori and other child protection staff. These issues are further corroborated by the records of the Respondent filed by the Applicant.

15At the time the Child was placed at DH, it was the only available placement in Ontario that could meet her needs. The Child was in hospital at the time and ready for discharge. Her prior placement had declined to have the Child return after discharge from hospital indicating it could not accommodate the Child’ special needs. Ms. Dottori testified that it was important for the Child to be able to remain at DH. Her evidence was that the Respondent’s senior management team held meetings with DH to determine if anything could be done to reverse the latter’s discharge decision. These efforts were not successful.

16In June 2024, DH advised the Respondent that the Child could remain at its facility until a suitable new placement could be found subject to conditions. These conditions related to the Applicant’s access to the Child, the Child’s medical appointments and medical records (MyChart) and, access to DH staff. The Respondent provided the Applicant, and her counsel, with a letter dated June 21, 2024 setting out the DH conditions for the Child to remain at DH pending further placement options being explored. The Respondent acknowledged in the June 21, 2024 letter that many of the conditions were invasive, however were necessary to protect the Child’s placement at DH. The Applicant did not deny receiving this correspondence from the Respondent. The Applicant continued to have access to the Child’s MyChart until September 2024 which was after she started this proceeding.

17The Child remains at DH subject to the conditions referenced in the preceding paragraph of this Decision.

18I find that reasons are not required for a move that did not take place.

19Regarding the notice of intent to discharge the Child, issued by DH, I find that the Respondent provided the Applicant with the reasons it was provided by DH for the discharge plan. The Applicant acknowledged the meeting with the Respondent regarding the DH discharge notice. She acknowledged being invited to have her lawyer and support persons present at this meeting and that they all had an opportunity to ask questions about the discharge notice. Further, the Applicant does not dispute receiving the letter from the Respondent in June 2024 which discussed the conditions for the Child to remain at DH, temporarily. Regarding the restrictions, the reasons were provided in that letter, being the importance of maintaining this specialized placement for the Child.

Issue 2: Has the Applicant been heard by the Respondent and provided with reasons for the care and services the Child is receiving?

20It was the Applicant’s evidence that she was restricted from access to the Child’s medical information and services. She testified that she was excluded from numerous meetings about the Child’s care starting in February 2023 and was not heard when she expressed concerns about proposed changes to the Child’s proposed care plan in March 2023. The Applicant testified that she was not provided with reasons for decisions that were made in relation to the Child’s care and that her input as the Child’s primary caregiver was dismissed.

21Prior to April 4, 2023, the Applicant had decision making authority for the Child. The Respondent was not involved in making decisions for the Child at the time. It was evident from the evidence, including portions of the Respondent’s record filed by the Applicant, that she did not have a good working relationship with the medical and residential treatment services providing services to the Child prior to April 4, 2023. I find the Respondent is not required, nor would it be able, to provide reasons for decisions it did not make. The Applicant made these decisions.

22Darlene McFarlane is a children’s services worker employed by the Respondent. She has been the Child’s children’s services worker since May 2023. Ms. McFarlane testified that the staff at DH work with the Complex Care Pediatrics team at McMaster Hospital which includes multiple specialty services for the Child. The Child also received physical and occupational therapy from another facility.

23It was Ms. McFarlane’s evidence that the Applicant had full access to the Child’s MyChart records until mid-September 2024 and has been aware of what appointments were scheduled for the Child and when. The Applicant’s access to the Child’s MyChart was removed at the request of DH due to DH’s concerns about the Applicant’s conduct such as attending medical appointments without notice, breaching conditions set by DH to the Child remaining in their residential program and, frequent communications by the Applicant with DH regarding appointments entries in the MyChart which was taking up a significant amount of DH staff time.

24Ms. McFarlane testified that she and other Respondent staff provided the Applicant with monthly updates and plans of care, general health updates and updates from the Child’s medical appointments. Ms. McFarlane provided a list of 38 dates between December 28, 2023 and October 21, 2024 when she testified that updates were provided to the Applicant in emails, and testified that she has continued to provide the Applicant with email updates as they are provided by DH and McMaster Hospital since October 21, 2024.

25In addition to the email updates, Ms. McFarlane’s evidence is that she had in-person conversations and telephone conversations (via TEAMS) with the Applicant about the Child’s care and, that the Applicant was provided a Plan of Care document every 180 days approximately which extensively outlined the services and care the Child was receiving. Ms. McFarlane testified that she was present for multiple medical and care related appointments for the Child that the Applicant also attended.

26During cross-examination, the Applicant acknowledged receiving the email updates and plans of care from the Respondent which Ms. McFarlane testified had been provided to her. She also acknowledged attending multiple plan of care meetings as well as appointments at McMaster Hospital. Ms. McFarlane and other child protection workers drove the Applicant from Kitchener, Ontario to these appointments in Hamilton, Ontario. The Applicant acknowledged that the drives provided her with additional opportunities to discuss the Child’s care and services with the child protection workers involved.

27Based on the Applicant’s evidence, the essence of her issue is that she was not present for the day-to-day care and services provided to the Child and was therefore unable to be involved in decisions that were made at the time they were made. In this regard, the Applicant testified that DH was not allowing her involvement in the Child’s day-to-day care, had excluded her from a plan of care meeting by DH in September 2024 and, had asked that its communications with her be through the Respondent.

28As previously noted, the parties all agree that the Child is extremely high needs and medically fragile. She requires a specialized placement. The evidence of the Respondent is that maintaining the Child’s placement was a priority and that it advised the Applicant of this. When DH indicated to the Respondent that it was prepared to continue the placement, subject to conditions related to the Applicant’s interactions with DH, access to the Child, and access to the Child’s medical placement, the Respondent agreed to the conditions in order to maintain the placement. I find that the Respondent provided the Applicant with reasons for the restrictions on her required by DH in order to maintain the placement.

29I find that the Respondent heard the Applicant regarding her concerns about her inability to be more involved in the Child’s treatment and day-to-day care and responded by keeping her informed of the care and services the Child was receiving including by way of monthly updates, plans of care, general health updates following medical appointments, in-person and telephone updates, accompanying the Applicant to multiple medical and care appointments for the Child and, providing the Applicant with opportunities to discuss the Child’s care and services during drives with the child protection worker from Kitchener to Hamilton to see the Child.

Issue 3: Did the Respondent provide the Applicant with reasons for the Child’s rapid health deterioration in 2023, if it was available?

30On or about May 7, 2023, the Child developed pneumonia and was transported to McMaster Hospital where she was admitted.

31The Applicant testified that the Respondent told her the pneumonia was the result of the progression of the Child’s disease, however, she stated that the Child does not have a degenerative disease and this reason is not supported by any medical record or report. The Applicant denied that the Child had previously suffered from pneumonia, however, this is contradicted in the Applicant’s January 16, 2025 witness statement, in which she states that the Child developed aspiration pneumonia four days after being placed at DH and on 7-8 more occasions over the next four months.

32Erin Brandon is a child protection worker for the Respondent and was assigned to work with the Applicant and the Child between September 16, 2022 and May 18, 2023. Ms. Brandon testified that the Child was admitted to hospital on May 7, 2023 with a query of viral pneumonia or aspiration pneumonia. Ms. Brandon provided evidence that the Child was always at high risk for respiratory complications and had previously been diagnosed with pneumonia several times. According to Ms. Brandon, the exact reason for the Child acquiring pneumonia on this occasion is not known.

33Ms. Brandon testified that she instructed McMaster Hospital that, although the Child was in the Respondent’s care, access by the Child’s parents was welcome and that medical information/updates could be provided to them.

34The Child’s condition deteriorated necessitating medical decisions including whether she should be intubated. Ms. Brandon testified that the Respondent decided the Child’s parents would make medical decisions regarding the Child’s care directives. This was acknowledged by the Applicant during cross-examination.

35Ms. Brandon testified that, throughout the Child’s hospitalization, the Applicant was provided with regular updates about the Child’s health status, that she had full access to the Child’s health care team and, she was provided with full disclosure as to the Child’s diagnosis of pneumonia.

36I find that the Respondent provided the Applicant with disclosure regarding the observations of staff at DH that alerted them to the Child potentially having a respiratory illness and arranging for her to be taken to hospital. The Respondent further provided the Applicant with full access to the Child’s medical team at McMaster Hospital. The Applicant had many opportunities to discuss the Child’s condition, including the cause of her pneumonia, with the Child’s doctors who would be in the best position to answer her questions which were medical in nature.

Issue 4: Did the Respondent provide the Applicant with reasons for its refusal to engage in Alternative Dispute Resolution (“ADR”)?

37The Applicant testified that she consistently requested the Respondent agree to ADR and the Respondent would not agree. During cross-examination, the Applicant acknowledged that she first requested mediation in October 2023, although she also suggested she had first raised it in July 2023. The Applicant clarified that, to her, ADR means mediation and family group conferencing.

38Ms. Dottori testified that the Respondent had not pursued mediation earlier as the Applicant did not propose a plan and the Respondent felt mediation would not be appropriate.

39On October 3, 2023, Ms. Dottori sent an email to the Applicant and her counsel. In her email, Ms. Dottori states there was a hybrid settlement conference/trial management conference “court conference”) scheduled for October 12, 2023. The Respondent was in the process of preparing for the court conference and would not schedule an ADR process until the parties had obtained further input from the assigned judge.

40The uncontroverted evidence of Ms. Dottori is that the October 12, 2023 court conference was adjourned at the request of Applicant’s counsel. It did not proceed until August 8, 2024. The Respondent provided that it was also waiting to receive third party records to gain a better understanding of the needs of the Child and the Applicant. The bulk of these records was only received in June 2024 and was voluminous.

41Ms. Dottori testified that ADR/mediation was discussed at the August 8, 2024 court attendance, and all parties consented to mediate. The mediation process was initiated with a child protection mediator and the first mediation took place on December 12, 2024.

42I find that, as of the date of the Application, the Respondent had not provided the Applicant with reasons for not agreeing to mediation or any other form of ADR. On October 3, 2024, Ms. Dottori did finally provide reasons for the Respondent not engaging in mediation, although it’s referenced as “Family Group Decision Making/ADR”. Once the court attendance referenced in the October 3, 2024 mediation took place, the parties agreed to mediate and have engaged in that process.

Issue 5: Did the Respondent provide the Applicant with reasons for not convening a Signs of Safety and/or Family Group Decision meeting?

43The Applicant testified to her understanding that Signs of Safety meetings follow a certain format and results in clarity as to expectations. She considers it a form of ADR. It was not clear from the Applicant’s evidence when she first requested a Signs of Safety meeting.

44Ms. Dottori testified that Signs of Safety is a “tool” and not a specific meeting type. More specifically, Ms. Dottori testified that Signs of Safety is a framework or approach with a view to working in partnership with families to increase safety to children and reduce risk. This approach is a conversation with the family about the safety of the children and building a joint understanding of the situation causing harm and what is required to ensure safety.

45Ms. Dottori testified that she has engaged in multiple meetings with the Applicant, her counsel, her supports and child advocates, that have all been centred on Signs of Safety.

46In her October 3, 2024 communication to the Applicant, Ms. Dottori advised the Applicant and her counsel that it would be helpful to understand what the Applicant believed a Signs of Safety meeting was and what her goal would be for such a meeting. In that communication, Ms. Dottori explained that a Signs of Safety is a template and tool used by the Respondent when facilitating family meetings. The Applicant did not respond to this communication.

47Regarding Family Group Decision Making, the Respondent concedes that it did not provide meaningful reasons for not engaging in this process. The Respondent acknowledges that it overlooked an email dated April 18, 2024 from the Applicant until the Respondent was preparing for this hearing. In that email, the Applicant asks the reasons for the Respondent refusing to allow a Family Group Decision Making conference and states that she has been asking for this multiple times over the previous nine months.

48I find that as of the date of the Application, the Respondent had not responded to the Applicant’ queries regarding Signs of Safety. However, the Respondent corrected this on October 3, 2024 in its email communication to the Applicant to which it did not receive a response.

49I find that the Respondent did not provide the Applicant with reasons for not holding a Family Group Decision Making conference.

ORDER

50As of the date of the Application, the Respondent did not provide the Applicant with reasons for not engaging in Alternative Dispute Resolution, for which no order is made.

51The Respondent responded to the Applicant’s queries regarding Signs of Safety on October 3, 2024 and received no reply from the Applicant. As such, no order is made in this regard.

52The Respondent shall provide the Applicant with reasons in writing for denying her requests for a Family Group Decision Conference within 21 days.

53The Application is otherwise dismissed.

CONFIDENTIALITY ORDER

54Pursuant to Rules 9.3 and 9.4 of the CFSRB’s Rules of Procedure, parties and their representatives must not use, share, discuss or disclose any CFSRB documents or decisions, or any other documents or information provided or used in this Application, with anyone including through the media or online. The CFSRB prohibits the use of any of this information for any purpose outside of the CFSRB’s proceedings, except with an order of the Court or the CFSRB, as appropriate.