Ellen Keates v. Michael Koile

FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

ELLEN KEATES; A. K., a minor, No. 16-16568

through her parent and guardian

Ellen Keates, D.C. No.

Plaintiffs-Appellants, 2:15-cv-01270-NVW

v.

OPINION

MICHAEL KOILE; KAREN

HOWARD; GILLIAN VANESSE;

RITA GOMEZ; SARAH JENKINS;

KIMBERLY PENDER; JOANNA

LENSCHE; AND STEVE

ROUNTREE, individually as

employees with the State of

Arizona Child Protective

Services; CLARENCE H.

CARTER, individually as

Director, Arizona Department

of Economic Security; STATE OF

ARIZONA, a political entity;

UNKNOWN PARTIES, John and

Jane Does 1–5; Black Entities

1–5,

Defendants-Appellees.

Appeal from the United States District Court

for the District of Arizona

Neil V. Wake, District Judge, Presiding

2 KEATES V. KOILE

Argued and Submitted December 4, 2017

San Francisco, California

Filed March 6, 2018

Before: Milan D. Smith, Jr. and Sandra S. Ikuta, Circuit

Judges, and John D. Bates,* District Judge.

Opinion by Judge Ikuta

SUMMARY**

Civil Rights

The panel affirmed in part and reversed in part the district

court’s dismissal of an action against Child Protective

Services officers and employees alleging constitutional

violations arising from defendants’ actions in removing a

minor child A.K. from her mother’s custody following A.K.’s

hospitalization for depression and suicidal ideation, and

remanded.

The panel held that this Circuit’s case law clearly

establishes that the rights of parents and children to familial

association under the Fourteenth, First, and Fourth

Amendments are violated if a state official removes children

*

The Honorable John D. Bates, United States District Judge for the

District of Columbia, sitting by designation.

**

This summary constitutes no part of the opinion of the court. It has

been prepared by court staff for the convenience of the reader.

KEATES V. KOILE 3

from their parents without their consent, and without a court

order, unless information at the time of the seizure, after

reasonable investigation, establishes reasonable cause to

believe that the child is in imminent danger of serious bodily

injury, and the scope, degree, and duration of the intrusion is

reasonably necessary to avert the specific injury at issue.

The panel held that the district court erred in dismissing

the familial association claim against defendants Koile and

Pender on the basis of qualified immunity. The panel held

that the operative complaint alleged sufficient facts to

establish that defendants violated plaintiffs’ constitutional

rights to familial association. The panel further determined

that a reasonable official in defendants’ position would have

known that the available information did not establish

reasonable cause to believe that A.K. was in imminent danger

of attempting to commit suicide, or that it was necessary to

separate her from her mother, transfer her to a treatment

center, and continue to detain her after medical professionals

concluded she was a low suicide risk.

The panel held that the district court did not err by

dismissing plaintiffs’ judicial deception claim. The panel

determined that it could not say that defendant’s statement in

the dependency petition was a deliberate falsehood or

constituted judicial deception in light of the specific context

of the case.

The panel held that there was sufficient evidence to make

a plausible allegation that defendants Lensche and Rountree

were integral participants in violating plaintiffs’

constitutional rights. As to the claims against four other

defendants, the panel held that the complaint did not offer any

plausible allegation that the defendants participated in the

4 KEATES V. KOILE

decision to interfere with plaintiffs’ constitutional rights, and

therefore the district court did not err in dismissing those

claims.

Finally, the panel held that the complaint did not allege

that the Director of the Arizona Department of Economic

Security was directly involved in the allegedly

unconstitutional conduct or that he had knowledge of the

constitutional deprivations and acquiesced in them. The

panel held that plaintiffs’ conclusory allegations that the

unconstitutional policies and procedures caused the

unconstitutional conduct did not suffice to state a claim of

supervisory liability.

COUNSEL

Geoff Morris (argued) and DeeAn Gillespie Strub, Gillespie

Shields Durrant & Goldfarb, Phoenix, Arizona, for Plaintiffs-

Appellants.

James B. Bowen (argued), Assistant Attorney General; Mark

Brnovich, Attorney General; Office of the Attorney General,

Phoenix, Arizona; for Defendants-Appellees.

OPINION

IKUTA, Circuit Judge:

Ellen Keates and her minor child, A.K., appeal the

dismissal of their claims against Michael Koile and other

officers and employees of what was then the Child Protective

Services (CPS) division of the Arizona Department of

KEATES V. KOILE 5

Economic Security (ADES), which allege (among other

things) violations of Keates’s and A.K.’s constitutional rights

to familial association.1 These claims all stem from CPS’s

actions to remove A.K. from her mother’s custody following

A.K.’s hospitalization for depression and suicidal ideation.

We conclude that certain of Keates’s and A.K.’s claims

against the defendants who allegedly participated in the

interference with familial association withstand the motion to

dismiss.

I

The operative complaint includes the following factual

allegations. In May 2013, A.K. was thirteen years old and

had been experiencing depression for four to six months, and

“[o]n occasion, she had suicidal ideations.” Ellen Keates is

the mother of A.K. On May 20, 2013, Keates took A.K. to

Christ Cares Clinic where A.K. told an employee that she was

sad and had contemplated suicide in the past, but stated that

she was not currently experiencing suicidal ideation. The

clinic employee referred A.K. to the emergency room at

Phoenix Children’s Hospital (PCH), where A.K. was seen by

a triage nurse and a doctor who ordered a psychological

consultation and evaluation by a social worker.

Notes from the triage nurse at PCH stated that A.K.

expressed feeling sad and depressed, admitted to having

suicidal ideation, “but denied having a plan to carry it out.”

Several hours later, Randy Call, a PCH employee, and Julie

1

The other defendants are Koile’s supervisor, Kimberly Pender, six

other CPS employees (Karen Howard, Gillian Vanesse, Rita Gomez,

Sarah Jenkins, Joanna Lensche, and Steve Rountree), and Clarence Carter,

Director of ADES.

6 KEATES V. KOILE

Kaplan, a PCH social worker, told Keates that A.K. could go

home if Keates provided a safety plan for A.K. Keates

offered several options, including having A.K. stay home

with her twelve-year old brother, having A.K. stay with a

neighbor, or dropping A.K. off at the public library. Call and

Kaplan rejected these options. Keates explained that she was

self-employed and staying at home would cost her some

business, but Keates nevertheless said she would stay home

with A.K.

Call and Kaplan then informed Keates that the decision

had been made to prevent A.K. from going home with

Keates, and that she was required to go to a mental hospital

for inpatient treatment. Keates stated that she lacked health

insurance to pay for inpatient treatment. When Call, Kaplan,

or another hospital staff person asked Keates for her contact

information, Keates said she was “unwilling to give PCH

agents information that could lead [her] to being billed for an

unnecessary, and increasingly costly, stay at PCH.” Keates

“furiously expressed her concern” to hospital staff that “PCH

was going to hold A.K. hostage until PCH received

information to bill [her].” Nevertheless, while talking to Call

and Kaplan, Keates did provide her name, phone number and

other contact information.

At some point after Keates had refused to provide contact

information for billing, “someone” from PCH called CPS to

report that “A.K. was suffering severe depression and had

attempted a suicide by strangulation on May 20, 2013.” PCH

staff told CPS that “inpatient care was necessary”—although

they had previously told Keates it was merely

recommended—and that Keates “was not able to enact a

safety plan.” Kaplan subsequently wrote a report stating that

“[b]ecause mother refused to provide any identifying

KEATES V. KOILE 7

information, other than [patient’s] name, CPS report was

made during assessment for fear that mother would take

[patient] and leave.” Randy Call spoke to or was referred to

CPS employees Joanna Lensche and Steve Rountree. CPS

employees Michael Koile, Kim Pender, and Gillian Vanesse

were also involved early in the investigation.

At the end of the discussion among Keates and PCH staff,

Kaplan told Keates that A.K. would be reassessed in the

morning and that Keates should go home and call PCH for

the results of the second assessment the next day. Keates

went home, but when she called the next morning, May 21,

she was told “there would be no second assessment and that

CPS had told PCH that Ms. Keates was not to have any

contact with A.K. and was not to come back to PCH.”

On the morning of May 21, Koile, a CPS case worker,

interviewed A.K. without Keates present and without

Keates’s consent. A.K. reported that her only complaint

about her mother was that she “yells, screams, and cusses.”

A.K. also told Koile that she had suicidal ideation in the past

but had not attempted suicide on May 20; the doctor at Christ

Cares Clinic had misunderstood her.

Later on May 21, around 11:45 A.M., Koile issued a

temporary custody notice (TCN) allowing him to take A.K.

away from Keates and put her into CPS custody. In preparing

and issuing this order, Koile collaborated with his colleagues,

Joanna Lensche and Steve Rountree, and had the advice,

consent and approval of his supervisor, Kim Pender. Keates

was not at the hospital at the time Koile issued the TCN. A

CPS case worker, Karen Howard, later wrote a letter to

Keates stating that CPS took custody of A.K. because Keates

did not have health insurance and was unwilling to share her

8 KEATES V. KOILE

contact information with PCH. Koile told PCH that Keates

was “prohibited from visiting A.K. during the remainder of

A.K.’s stay at PCH.”

A.K. was discharged from PCH on May 21, 2013. She

was strapped to a gurney and delivered by ambulance to

Aurora Behavioral Health System (ABHS) in Tempe,

Arizona. During intake at ABHS, Koile told the intake nurse

that A.K. had tried to commit suicide on May 20, 2013. But

A.K. told the intake nurse that she “did not have, at that time,

any [suicidal ideation]” and while “she had some [suicidal

ideation] over the course of the previous several months,” she

had no plan to commit suicide. She stated that “she was

depressed but she did not feel like she needed to be here” and

told the intake nurse that the doctor at Christ Cares Clinic

“misunderstood her in that A.K. had thoughts of choking

herself in the past, but that was a while ago and she did not

feel like that now.” The intake nurse at ABHS found A.K.’s

suicide risk to be low.

A.K. remained at ABHS despite the intake nurse’s

conclusion that she was low risk. A.K. expressed her desire

to go home and her anger at not being able to have any

contact with her mother. Nevertheless, Koile directed ABHS

not to allow Keates to have contact with A.K.

On May 22, 2013, Koile interviewed Keates, who told

him that A.K. did not attempt suicide on May 20. The next

day, Koile informed ABHS that he had concluded that Keates

was unable to care for A.K. and that a dependency petition

would be filed. The Arizona Department of Economic

Security filed a dependency petition on behalf of CPS on May

24, 2013. The petition stated that A.K. attempted suicide on

May 20, 2013.

KEATES V. KOILE 9

Koile told Keates that A.K. would be required to receive

“intensive outpatient treatment at ABHS” and that if Keates

“could not make financial arrangements for that care, A.K.

was not going home.” On May 29, 2013, A.K. was

discharged from ABHS, which again assessed her as having

a low risk for suicide. ABHS told Keates that A.K. did not

need intensive outpatient treatment, and that it “rarely ever

provides such treatment.”

After she was discharged from ABHS, A.K. was placed

in a foster home. She did not receive intensive outpatient

treatment or her prescribed psychotropic drugs. She was

placed in a shelter when her foster mother went on vacation

and was later placed in a group home. The group home

initially failed to transport A.K. to high school, where she had

been accepted into the honors program, and only later

provided transportation pursuant to a court order. After

spending nearly four months outside of her mother’s custody,

A.K. returned home on September 12, 2013. The dependency

petition was dismissed on November 26, 2013.

Keates, on behalf of herself and A.K., filed this action in

state court, and the defendants removed the case to federal

court. Keates filed the operative complaint, which alleged

that the defendants had violated Keates’s and A.K.’s

constitutional rights to familial association under the First,

Fourth, and Fourteenth Amendments and the right to be free

from deliberately falsified evidence in dependency

proceedings, among other claims. The complaint also alleged

various state law claims.

The district court dismissed Keates’s constitutional claims

with prejudice on the ground that all defendants were entitled

to qualified immunity. The district court concluded that

10 KEATES V. KOILE

Koile did not violate Keates’s and A.K.’s constitutional rights

to familial association because Koile had reasonable cause to

believe that A.K. was in imminent danger of serious bodily

injury, and the scope of the intrusion was reasonably

necessary to avert that injury. Further, the district court held

that the complaint did not allege facts sufficient to establish

that Koile presented deliberately fabricated evidence to the

juvenile court. It remanded the remaining state claims to

state court. Keates and A.K. timely appealed.

II

We review a district court’s grant of a motion to dismiss

and issues of qualified immunity de novo. Price v. Hawaii,

939 F.2d 702, 706 (9th Cir. 1991). The district court had

jurisdiction under 28 U.S.C. § 1331. We have jurisdiction

under 28 U.S.C. § 1291.

At the motion-to-dismiss stage, we take all well-pleaded

factual allegations in the complaint as true, construing them

“in the light most favorable to the nonmoving party,” Silvas

v. E*Trade Mortg. Corp., 514 F.3d 1001, 1003 (9th Cir.

2008), and then determine “whether they plausibly give rise

to an entitlement to relief,” Ashcroft v. Iqbal, 556 U.S. 662,

679 (2009).

This appeal raises an additional wrinkle because the

district court granted the motion to dismiss largely on the

ground that defendants were entitled to qualified immunity.

Determining claims of qualified immunity at the motion-to-

dismiss stage raises special problems for legal decision

making. See Kwai Fun Wong v. United States, 373 F.3d 952,

956–57 (9th Cir. 2004). On the one hand, we may not

dismiss a complaint making “a claim to relief that is plausible

KEATES V. KOILE 11

on its face.” Iqbal, 556 U.S. at 678 (quoting Bell Atl. Corp.

v. Twombly, 550 U.S. 544, 570 (2007)). But on the other

hand, defendants are entitled to qualified immunity so long as

“their conduct does not violate clearly established statutory or

constitutional rights of which a reasonable person would have

known.” Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982).

The Supreme Court has emphasized that this is a low bar,

explaining that “[q]ualified immunity gives government

officials breathing room to make reasonable but mistaken

judgments about open legal questions.” Ashcroft v. al-Kidd,

563 U.S. 731, 743 (2011). Indeed, “[w]hen properly

applied,” qualified immunity protects “all but the plainly

incompetent or those who knowingly violate the law.” Id.

(quoting Malley v. Briggs, 475 U.S. 335, 341 (1986)).

Balancing these competing rules, when a district court

dismisses a complaint for failure to state a claim based on a

qualified immunity defense, we consider whether the

complaint alleges sufficient facts, taken as true, to support the

claim that the officials’ conduct violated clearly established

constitutional rights of which a reasonable officer would be

aware “in light of the specific context of the case.” Mullenix

v. Luna, 136 S. Ct. 305, 308 (2015) (per curiam) (quoting

Brosseau v. Haugen, 543 U.S. 194, 198 (2004) (per curiam)).

If the operative complaint “contains even one allegation of a

harmful act that would constitute a violation of a clearly

established constitutional right,” then plaintiffs are “entitled

to go forward” with their claims. Pelletier v. Fed. Home

Loan Bank of San Francisco, 968 F.2d 865, 872 (9th Cir.

1992). But our decision at the motion-to-dismiss stage sheds

little light on whether the government actors might ultimately

be entitled to qualified immunity “were the case permitted to

proceed, at least to the summary judgment stage” and the

12 KEATES V. KOILE

court is presented with facts providing context for the

challenged actions. Kwai Fun Wong, 373 F.3d at 957.

III

Because the operative complaint here was dismissed on

qualified immunity grounds, we must determine whether

Keates and A.K.’s complaint pleads a plausible claim that

withstands a qualified immunity defense. We review a grant

of qualified immunity de novo. Prison Legal News v.

Lehman, 397 F.3d 692, 698 (9th Cir. 2005).

In determining whether a government official is entitled

to qualified immunity, we consider two different questions:

(1) whether, “[t]aken in the light most favorable to the party

asserting the injury, . . . the facts alleged show the officer’s

conduct violated a constitutional right”; and (2) if so,

“whether the right was clearly established.” Saucier v. Katz,

533 U.S. 194, 201 (2001), overruled on other grounds by

Pearson v. Callahan, 555 U.S. 223, 236–42 (2009).

A

The operative complaint’s primary claim is that the

defendants violated Keates’s and A.K.’s rights to familial

association. Therefore, we begin by looking to our case law

to delineate the scope of the constitutional right to familial

association at issue in this case. This right is entirely judge-

made; it does not appear in the text of the Constitution itself.

Nor have courts been entirely clear regarding the source of

the right; they have variously relied on the Fourteenth, First,

and Fourth Amendments.

KEATES V. KOILE 13

The Fourteenth Amendment prohibits states from

depriving “any person of life, liberty, or property, without due

process of law.” U.S. Const. amend. XIV § 1. The Supreme

Court has stated that “the interest of parents in the care,

custody, and control of their children—is perhaps the oldest

of the fundamental liberty interests recognized by this Court.”

Troxel v. Granville, 530 U.S. 57, 65 (2000) (plurality

opinion); see also Santosky v. Kramer, 455 U.S. 745, 753

(1982) (addressing the “Court’s historical recognition that

freedom of personal choice in matters of family life is a

fundamental liberty interest protected by the Fourteenth

Amendment”). Courts have characterized the right to familial

association as having both a substantive and a procedural

component. While the right is a fundamental liberty interest,

see, e.g., Rosenbaum v. Washoe County, 663 F.3d 1071, 1079

(9th Cir. 2011); Smith v. City of Fontana, 818 F.2d 1411,

1418 (9th Cir. 1987), overruled on other grounds by

Hodgers-Durgin v. De La Vina, 199 F.3d 1037 (9th Cir.

1999) (en banc), officials may interfere with the right if they

“provide the parents with fundamentally fair procedures,”

Santosky, 455 U.S. at 753–54.

The First Amendment also protects “family relationships,

that presuppose ‘deep attachments and commitments to the

necessarily few other individuals with whom one shares not

only a special community of thoughts, experiences, and

beliefs but also distinctively personal aspects of one’s life.’”

Lee v. City of Los Angeles, 250 F.3d 668, 685 (9th Cir. 2001)

(quoting Board of Dirs. v. Rotary Club, 481 U.S. 537, 545

(1987)). This right was first identified in Roberts v. United

States Jaycees, which indicated that protecting intimate

relations “from unwarranted state interference” was necessary

to safeguard “the ability independently to define one’s

identity that is central to any concept of liberty.” 468 U.S.

14 KEATES V. KOILE

609, 619 (1984). The Court subsequently confirmed that “the

First Amendment protects . . . family relationships.” Board

of Dirs., 481 U.S. at 545. Accordingly, we have held that

claims under both the First and Fourteenth Amendment for

unwarranted interference with the right to familial association

could survive a motion to dismiss. See Lee, 250 F.3d at 686.

In addition to the Fourteenth and First Amendment rights

to familial association, “[w]e evaluate the claims of children

who are taken into state custody under the Fourth

Amendment right to be free from unreasonable seizures rather

than the Fourteenth Amendment right to familial

association.” Kirkpatrick v. County of Washoe, 792 F.3d

1184, 1189 (9th Cir. 2015), on reh’g en banc, 843 F.3d 784

(9th Cir. 2016) (internal quotation marks omitted); see also

Wallis v. Spencer, 202 F.3d 1126, 1137 n.8 (9th Cir. 2000)

(holding that the childrens’ claims “should properly be

assessed under the Fourth Amendment”). Despite the

different constitutional source of the right, we have held that

“the same legal standard applies in evaluating Fourth and

Fourteenth Amendment claims for the removal of children.”

Wallis, 202 F.3d at 1137 n.8.

We have woven these constitutional threads into a

discrete constitutional right in cases where state officials

remove children from parents without consent or due process.

Our cases hold that the Fourteenth, First, and Fourth

Amendments provide a guarantee “that parents will not be

separated from their children without due process of law

except in emergencies.” Mabe v. San Bernardino Cty., Dep’t

of Pub. Soc. Servs., 237 F.3d 1101, 1107–09 (9th Cir. 2001).

Officials may not remove children from their parents without

a court order unless they have “information at the time of the

seizure that establishes reasonable cause to believe that the

KEATES V. KOILE 15

child is in imminent danger of serious bodily injury.” Rogers

v. County of San Joaquin, 487 F.3d 1288, 1294 (9th Cir.

2007) (internal quotation marks omitted). Such “reasonable

cause” arises, for example, where there is evidence of

imminent abuse after sufficient investigation. Thus “[s]erious

allegations of abuse that have been investigated and

corroborated” may give rise to a reasonable inference that

children “might again be beaten or molested during the time

it would take to get a warrant” unless the official takes the

children into temporary custody. Id. at 1294–95. Lack of

health insurance, by contrast, does not provide a reasonable

cause to believe a child is in imminent danger. Id. at 1296.

An official “cannot seize children suspected of being

abused or neglected unless reasonable avenues of

investigation are first pursued.” Wallis, 202 F.3d at 1138; see

id. (quoting BeVier v. Hucal, 806 F.2d 123, 128 (7th Cir.

1986), for the proposition that an officer has a duty to “make

a thorough investigation and exercise reasonable judgment

before invoking the awesome power of arrest and detention”).

Further, because the “scope of the intrusion” must be

“reasonably necessary to avert” a specific injury, the intrusion

cannot be longer than necessary to avert the injury. Id. at

1140–41 (indicating that children could be held away from

their parents only for so long as the emergency existed).

In Wallis v. Spencer, for instance, we considered a claim

brought by parents and their two young children against the

City of Escondido after police officers seized their children

without a court order. Id. at 1131. The seizure occurred after

the mother’s institutionalized and severely mentally ill sister

told her therapist that her brother-in-law was planning to

sacrifice his young son to Satan on the Fall Equinox. Id. The

therapist reported this threat, which ultimately made its way

16 KEATES V. KOILE

to the police, who entered the family’s home around midnight

and took custody of the children and transported them to a

county institution. Id. at 1132–34. Without parental presence

or consent, the children were taken to a local hospital where

they were subjected to internal body cavity examinations to

determine whether abuse had occurred. Id. at 1135. They

remained in state custody for two and a half months before

being returned to their parents. Id. at 1134.

Proceeding under the Fourteenth Amendment (as to the

claims of the parents) and the Fourth Amendment (as to the

claims of the children), but applying the same legal standard,

see id. at 1137 n.8, Wallis held that there were genuine issues

of material fact as to whether the police had reasonable cause

to believe that the children “faced an immediate threat of

serious physical injury or death,” and whether “the actions

taken by the officers—removing the children from their

mother and placing them in an institution—exceeded the

permissible scope of the action necessary to protect them

from that immediate threat,” id. at 1138 (emphasis omitted).

There were triable issues of fact as to whether the officers had

pursued reasonable avenues of investigation, and whether

“the scope and degree of the state interference was justified

by the alleged exigency.” Id. at 1140. In particular, because

the police had no information that the alleged sacrifice plot

extended beyond the Equinox, there was a genuine issue of

material fact “as to whether the emergency continued to exist

for more than the brief day or two following the time of the

children’s seizure.” Id. Wallis did not address the question

whether the City could be held liable for detention of the

children after their removal was approved by a juvenile court.

Id. at 1141.

KEATES V. KOILE 17

In sum, our case law clearly establishes that the rights of

parents and children to familial association under the

Fourteenth, First, and Fourth Amendments are violated if a

state official removes children from their parents without

their consent, and without a court order, unless information

at the time of the seizure, after reasonable investigation,

establishes reasonable cause to believe that the child is in

imminent danger of serious bodily injury, and the scope,

degree, and duration of the intrusion are reasonably necessary

to avert the specific injury at issue.

B

Turning to the first of the two qualified immunity

inquiries, we must now determine whether the operative

complaint alleges sufficient facts, accepted as true and

construed in the light most favorable to Keates and A.K., to

establish that Koile and the other defendants violated

Keates’s and A.K’s constitutional rights to familial

association. For the reasons that follow, we conclude that the

allegations are sufficient to state “a claim to relief that is

plausible on its face.” Iqbal, 556 U.S. at 678 (quoting

Twombly, 550 U.S. at 570).

Based on the allegations in the complaint, Koile’s

exercise of authority over A.K. interfered with Keates’s

relationship with A.K. First, on May 21, Koile detained A.K.

at PCH and had hospital staff inform Keates that she could

not have contact with her daughter or take her home. Further,

Koile interfered with the right of familial association by

issuing a TCN on May 21, and transporting A.K. strapped to

a gurney by ambulance to ABHS the same day, where she

was held without her parent’s consent and without a court

order. See Wallis, 202 F.3d. at 1134–35.

18 KEATES V. KOILE

These actions would not constitute a violation of Keates’s

and A.K.’s rights to familial association if the defendants had

information at the time of the seizure, after reasonable

investigation, giving rise to a reasonable cause to believe that

A.K. was in imminent danger of serious bodily injury, and if

the scope of the intrusion was reasonably necessary to

prevent serious bodily injury. See id. at 1138. Based on the

allegations of the complaint, however, these requirements

were not met. Although Koile could have given weight to the

call from “someone” at PCH on May 20 stating that A.K. had

tried to commit suicide, the allegations in the complaint

establish that Koile did not undertake a reasonable

investigation as to whether A.K. was in imminent danger due

to her mother’s presence. According to the complaint, Koile

did not corroborate the PCH call to CPS or obtain other

medical opinions on whether A.K. was at risk. Because both

Keates and A.K. repeatedly informed Koile that A.K. was not

actively suicidal, a reasonable official in Koile’s position

would have known that further investigation was necessary.

Moreover, after Koile issued a TCN and transferred A.K. to

ABHS, the intake nurse at ABHS determined that A.K. was

“low-risk” for suicide, further undercutting any reasonable

belief that A.K. was in imminent danger. Nevertheless, the

complaint alleges that A.K. was detained at ABHS at least

two more days before Koile sought a court order. See id. at

1140 (stating that “the scope and degree of the state

interference” must be “justified by the alleged exigency”).

The complaint further alleges facts plausibly indicating

that Koile had sufficient time to obtain a warrant. See

Rogers, 487 F.3d at 1294. On May 20, when Koile first

talked to A.K., she was in a hospital and under medical

supervision. According to the complaint, Keates did not

attempt to remove A.K. from PCH but allowed her to stay

KEATES V. KOILE 19

overnight and merely called for a status report the next day.

“[T]he unlikely possibility” that Keates might “unexpectedly

abscond” with A.K. does not “justify dispensing with the

warrant requirement.” See Kirkpatrick v. County of Washoe,

843 F.3d 784, 792 (9th Cir. 2016) (en banc). Although PCH

was concerned about Keates’s lack of health insurance and

her ability to pay for treatment, such a concern does not give

rise to an imminent danger that would allow the state to

dispense with obtaining a court order. Rogers, 487 F.3d at

1296.

Finally, the complaint plausibly indicates that Koile

exceeded the scope of any intrusion necessary to protect A.K.

See Wallis, 202 F.3d at 1140. Based on the allegations in the

complaint, there was no basis for preventing Keates from

having contact with A.K. According to the complaint, A.K.’s

only concern about her mother was that she “yells, screams,

and cusses”; nothing in the complaint indicates that Keates

was involved in any past or planned future abuse of A.K. or

that contact with Keates would lead to injury. See id. at

1140–41. There was also no basis for requiring A.K. to be

strapped to a gurney when she was transported to ABHS,

because nothing in the complaint suggests A.K. posed an

imminent danger to herself that might justify such restraints.

Detaining A.K. at ABHS also exceeded the necessary scope

of any intrusion because ABHS’s assessment made clear that

any threat of immediate harm had dissipated. See id. at 1140.

Accordingly, we conclude that the operative complaint

plausibly alleges that Koile violated Keates’s and A.K.’s

rights to familial association.2

2

Although the complaint is not entirely clear, it indicates that at some

point after defendants filed a dependency petition in Arizona state court

on May 24, 2013, the court issued an order making A.K. a temporary ward

20 KEATES V. KOILE

Turning to the second prong of the qualified immunity

inquiry, “whether the right was clearly established,” Saucier,

533 U.S. at 201, we must determine whether it was so clear

that Koile’s actions violated Keates’s and A.K.’s rights to

familial association that any reasonable officer “would have

understood that what he is doing violates [those] right[s].”

Reichle v. Howards, 566 U.S. 658, 664 (2012) (internal

quotation marks and alteration omitted). “We do not require

a case directly on point, but existing precedent must have

placed the statutory or constitutional question beyond

debate.” Al-Kidd, 563 U.S. at 741. We must undertake this

inquiry “in light of the specific context of the case, not as a

broad general proposition.” Mullenix, 136 S. Ct. at 308

(quoting Brosseau, 543 U.S. at 198).

Koile argues that the facts alleged in the complaint show

that a reasonable officer in Koile’s position would not have

known that his specific actions violated Keates’s and A.K.’s

constitutional rights. Koile argues that he acted reasonably

because he was told by “qualified medical providers” at PCH

that A.K. was actively suicidal and needed inpatient

treatment. According to Koile, this information, along with

allegations in the complaint that the care provider at Christ

Cares Clinic referred A.K. to the emergency room, that

Keates refused to provide contact information because she

believed that the hospital was attempting to hold A.K.

of the state, and did not terminate this condition until November 25, 2013.

We have previously left open the question whether an official defendant

could be “held liable for any detention of [a child] after [the child’s]

removal was approved by the juvenile court.” Wallis, 202 F.3d at 1141.

Because Keates has not fully addressed this issue in her briefs, we leave

it to the district court on remand to determine whether events after the date

of the juvenile court hearing violated Keates’s and A.K.’s constitutional

rights.

KEATES V. KOILE 21

hostage until it obtained information for billing, and that CPS

was concerned that A.K.’s mother would remove A.K. from

care if CPS did not act immediately, shows that Koile was

reasonable in taking immediate action to protect A.K. and to

insure that she got the care that heath care professionals said

that she needed.

We disagree, because Koile’s arguments are not

supported by the complaint. Most important, nothing in the

complaint indicates that qualified medical professionals at

PCH advised CPS that A.K. was actively suicidal; it states

only that “someone from PCH” called CPS with that

information and with the recommendation that inpatient care

was necessary. The complaint alleges that Keates and A.K.

arrived at PCH Emergency voluntarily on the advice of Christ

Cares Clinic, and does not allege that the clinic warned PCH

that A.K. was in imminent danger. Nor does the complaint

contain facts establishing that a reasonable officer in Koile’s

situation would have been concerned that Keates might take

A.K. home against medical advice. The complaint alleges

that Keates did provide Call and Kaplan with her contact

information, and that Keates left A.K. in the hospital

overnight and merely called in the next morning. Further,

there is no allegation in the complaint that Koile was aware

of Kaplan’s report that PCH was concerned that “mother

would take [patient] and leave.”

Accordingly, based solely on the facts alleged in the

complaint construed in favor of Keates and A.K., a

reasonable official in Koile’s position would know the

available information did not establish reasonable cause to

believe that A.K. was in imminent danger of attempting to

commit suicide, or that it was necessary to separate her from

her mother, transfer her to ABHS, and continue to detain her

22 KEATES V. KOILE

after medical professionals at ABHS concluded she was a low

suicide risk. Therefore, we conclude that the operative

complaint alleges facts that allow us “to draw the reasonable

inference that the defendant is liable for the misconduct

alleged.” Iqbal, 556 U.S. at 678. The district court therefore

erred in dismissing the familial association claim against

Koile and Pender on the basis of qualified immunity.

However, “[o]ur denial of qualified immunity at this stage of

the proceedings does not mean that this case must go to trial.”

O’Brien v. Welty, 818 F.3d 920, 936 (9th Cir. 2016). As we

have previously noted, “[o]nce an evidentiary record has been

developed through discovery, defendants will be free to move

for summary judgment based on qualified immunity.” Id.

IV

We now turn to Keates’s and A.K.’s claim that the

defendants violated their due process right to be free from

deliberately false statements during juvenile court

proceedings. In order to prevail on a judicial deception claim,

a plaintiff must prove that “(1) the defendant official

deliberately fabricated evidence and (2) the deliberate

fabrication caused the plaintiff’s deprivation of liberty.”

Spencer v. Peters, 857 F.3d 789, 798 (9th Cir. 2017). If a

state official “submitted an affidavit that contained statements

he knew to be false or would have known were false had he

not recklessly disregarded the truth, . . . he cannot be said to

have acted in a reasonable manner, and the shield of qualified

immunity is lost.” Chism v. Washington State, 661 F.3d 380,

393 (9th Cir. 2011) (quoting Branch v. Tunnell, 937 F.2d

1382, 1387 (9th Cir. 1991)).

We again begin by determining whether the operative

complaint alleges sufficient facts, accepted as true and

KEATES V. KOILE 23

construed in the light most favorable to Keates and A.K., to

establish that their due process rights were violated. The

complaint makes a single factual allegation supporting this

claim, namely that the dependency petition used to obtain a

court order “falsely stated that A.K. attempted suicide on

May 20, 2013 even though A.K. specifically told Mr. Koile,

PCH employees, or agents, and ABHS employees, or agents,

that she did not attempt a suicide on May 20, 2013 and at any

time in the recent past.” The complaint does not, however,

provide a basis for concluding that Koile’s inclusion of the

statement that A.K. attempted suicide was a deliberate

falsehood. The complaint states that “someone” at PCH

reported to CPS that “A.K. was suffering severe depression

and had attempted a suicide by strangulation on May 20,

2013,” and a reasonable officer in Koile’s position could have

given more weight to this information from the hospital than

to the denials from Keates and A.K.

It is a closer question whether the statement in the

dependency petition that A.K. attempted suicide was made

with reckless disregard for the truth. By the time the

dependency petition was filed on May 24, Koile should have

been aware of ABHS’s diagnosis on May 21 that A.K. was at

low risk for suicide and he would have had time to investigate

the PCH report about A.K.’s suicide attempt. Nevertheless,

ABHS’s prediction of A.K.’s suicide risk in the future does

not directly contradict the statement from “someone” at PCH

that A.K. had attempted suicide on May 20. Given that

qualified immunity is intended to give officials “breathing

room to make reasonable but mistaken judgments,” Al-Kidd,

563 U.S. at 743, we conclude that the complaint did not

plausibly allege that Koile knew or recklessly disregarded the

truth when he included this statement in the dependency

petition.

24 KEATES V. KOILE

Accordingly, even assuming all the allegations in the

complaint are true, we cannot say that Koile’s statement in

the dependency petition was a deliberate falsehood or

constituted judicial deception, “in light of the specific context

of the case,” Mullenix, 136 S. Ct. at 308. Therefore, the

district court did not err in granting the motion to dismiss this

claim.

V

We next turn to Keates’s and A.K’s arguments that the

district court erred in dismissing the claims against Carter,

Howard, Vanesse, Gomez, Jenkins, Lensche and Rountree.

These defendants cannot be held liable for a constitutional

violation under 42 U.S.C. § 1983 unless they were integral

participants in the unlawful conduct. Chuman v. Wright,

76 F.3d 292, 295 (9th Cir. 1996). We have held that

defendants can be liable for “integral participation” even if

the actions of each defendant do not “rise to the level of a

constitutional violation.” Boyd v. Benton County, 374 F.3d

773, 780 (9th Cir. 2004). In Boyd, for instance, the plaintiff

brought suit under § 1983 against city and county police

officers for injuries incurred when the police threw a flash-

bang device into an apartment prior to a search. Although a

single officer threw the device into the apartment, we held

that the other officers involved in the operation were “integral

participants” because: (1) they stood armed behind the

individual deploying the flash-bang; (2) “the use of the flash-

bang was part of the search operation in which every officer

participated in some meaningful way”; and (3) “every officer

was aware of the decision to use the flash-bang, did not object

to it, and participated in the search operation knowing the

flash-bang was to be deployed.” Id. Accordingly, we

concluded that the participating officers could be liable for

KEATES V. KOILE 25

the constitutional violation. Id. We reached a different

conclusion in Sjurset v. Button, 810 F.3d 609 (9th Cir. 2015).

In that case, where the decision to remove children from their

parents’ home was made by a state agency, and there were no

facts suggesting that police officers who actually removed the

children were “privy to any discussions, briefings or

collective decisions” made by the agency “in its protective-

custody determination,” we held that the police officers could

not be held liable for violating the family’s constitutional

rights. Id. at 619.

On a motion to dismiss, we must determine whether the

complaint plausibly alleges that each of the defendants was

an integral participant in the violation of Keates’s and A.K.’s

rights to familial association. The complaint alleges that

Lensche and Rountree, who were employees of CPS, spoke

to Randy Call, a PCH employee who informed Keates that

A.K. was not allowed to leave, and that Lensche and

Rountree “collaborated in the issuance of the TCN.” These

allegations, though sparse, indicate that Lensche and

Rountree were aware of A.K.’s situation at PCH and

participated in a meaningful way in a collective decision to

issue a TCN. The TCN was central to the alleged

constitutional violation, as it was the basis for Koile’s seizure

and removal of A.K. to ABHS. Accordingly, we conclude

that this is sufficient—though just barely—to make a

plausible allegation that Lensche and Rountree were integral

participants in violating Keates’s and A.K.’s constitutional

rights. Therefore, the district court erred in finding that the

operative complaint failed to state a claim against Lensche

and Rountree.

The complaint’s allegations against Howard, Vanesse,

Gomez, and Jenkins are insufficient, however, to show

26 KEATES V. KOILE

integral participation. For example, the complaint alleges

that PCH employees spoke to CPS supervisor Gillian Vanesse

on the morning of May 21, and that she was otherwise

“involved early in the investigation.” There is no allegation,

however, that Vanesse “collaborated in the issuance of the

TCN.” The complaint also alleges that social worker Karen

Howard sent a letter to Keates in September 2013, stating that

CPS took custody of A.K. because Keates lacked insurance

and did not willingly share her contact information with PCH.

This occurred months after CPS initially took custody of

A.K., however, and the complaint does not allege any

participation by Howard before then. Nor does the complaint

make any specific allegations regarding Gomez or Jenkins.

Because the complaint does not offer any plausible allegation

that any of these CPS employees participated in the decision

to interfere with Keates’s and A.K.’s constitutional rights, the

district court did not err in dismissing the claims against

them.3

Finally, the complaint alleges that Carter was an “official

policymaker” for CPS and “was responsible for

[implementation] of those policies in a manner that violated

Plaintiffs’ constitutional rights.” Further, the complaint

alleges that “all or some of the unconstitutional actions or

conduct . . . are the direct result of the unconstitutional

policies, procedures and practices promulgated by Defendant

3

Keates’s argument that she should be excused from making the

necessary factual allegations because she was not in a position to know all

relevant factual details of the defendants’ involvement in the removal

decision is unavailing. See Iqbal, 556 U.S. at 678–79 (holding that “only

a complaint that states a plausible claim for relief survives a motion to

dismiss” and the federal rules allowing notice pleading “do not unlock the

doors of discovery for a plaintiff armed with nothing more than

conclusions.”).

KEATES V. KOILE 27

Carter.” The complaint does not allege that Carter knew of

or was directly involved in the decisions leading to CPS

taking custody of A.K.

Because vicarious liability is inapplicable to § 1983 suits,

“a plaintiff must plead that each Government-official

defendant, through the official’s own individual actions, has

violated the Constitution.” Iqbal, 556 U.S. at 676. A

supervisory official may be held liable under § 1983 only “if

there exists either (1) his or her personal involvement in the

constitutional deprivation, or (2) a sufficient causal

connection between the supervisor’s wrongful conduct and

the constitutional violation.” Starr v. Baca, 652 F.3d 1202,

1207 (9th Cir. 2011) (quoting Hansen v. Black, 885 F.2d 642,

646 (9th Cir. 1989) (internal quotation marks omitted)). Even

if a supervisory official is not directly involved in the

allegedly unconstitutional conduct, “[a] supervisor can be

liable in his individual capacity for his own culpable action or

inaction in the training, supervision, or control of his

subordinates; for his acquiescence in the constitutional

deprivation; or for conduct that showed a reckless or callous

indifference to the rights of others.” Id. at 1208 (quoting

Watkins v. City of Oakland, 145 F.3d 1087, 1093 (9th Cir.

1998)). Therefore, the claim that a supervisory official knew

of unconstitutional conditions and “culpable actions of his

subordinates” but failed to act amounts to “acquiescence in

the unconstitutional conduct of his subordinates” and is

“sufficient to state a claim of supervisory liability.” Id.

The complaint here does not allege that Carter was

directly involved in the allegedly unconstitutional conduct or

that he had knowledge of the constitutional deprivations and

acquiesced in them. Rather, the complaint makes conclusory

allegations that Carter promulgated unconstitutional polices

28 KEATES V. KOILE

and procedures which authorized the particular conduct in

this case and thus directly caused Koile’s allegedly

unconstitutional conduct. These allegations do not suffice to

state a claim of supervisory liability. A court is “not bound

to accept as true a legal conclusion couched as a factual

allegation,” Iqbal, 556 U.S. at 678 (quoting Twombly,

550 U.S. at 555), or “an unadorned, the-defendant-

unlawfully-harmed-me accusation,” id. Because the

conclusory allegations in the complaint are speculative and do

not state a plausible claim for relief against Carter, the district

court did not err in dismissing him.

VI

We reverse the district court’s dismissal of Keates’s and

A.K.’s claim for violation of their constitutional right to

familial association on qualified immunity grounds, affirm

the district court’s dismissal of their claim for violation of

their due process right to be free from deliberately false

statements in state court dependency proceedings, reverse the

dismissal of the claim that Lensche and Rountree violated

their constitutional right to familial association, and affirm

the dismissal of that claim against Carter, Vanesse, Howard,

Gomez, and Jenkins. Each party will bear their own costs on

appeal.

AFFIRMED IN PART, REVERSED IN PART, AND

REMANDED.