People v. Ramos CA4/1

Opinion

Filed 8/31/26 P. v. Ramos CA4/1 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

COURT OF APPEAL, FOURTH APPELLATE DISTRICT

DIVISION ONE

STATE OF CALIFORNIA

THE PEOPLE, D087439

Plaintiff and Respondent, (Super. Ct. No. RIF2206133) v.

JOSE ALVAREZ RAMOS,

Defendant and Appellant.

APPEAL from a judgment of the Superior Court of Riverside County, Sophia Choi, Judge. Affirmed. Cindy Brines, under appointment by the Court of Appeal, for Defendant and Appellant. Rob Bonta, Attorney General, Charles C. Ragland, Chief Assistant Attorney General, Arlene A. Sevidal, Assistant Attorney General, A. Natasha Cortina and Alan L. Amann, Deputy Attorneys General, for Plaintiff and Respondent. Jose Alvarez Ramos was tried in 2024 on six counts of child molestation. Over the course of a 10-day trial, the jury heard testimony from four of Ramos’s adult nieces: YH, EM, AH, and CH. Each niece testified that, more than two decades earlier, when she was between the ages of 7 and 10 and entrusted to Ramos’s care, Ramos had on various occasions sexually molested her. Ramos was convicted on three of the six counts, acquitted but convicted of a lesser included offense on a fourth count, acquitted outright on the two remaining counts, and then sentenced to a term of imprisonment of seven years plus 45 years to life. On appeal, Ramos contends all four convictions should be reversed. With respect to two of the convictions, he contends the prosecution engaged in vindictive prosecution. As to all four convictions, he further contends that the trial court abused its discretion in admitting evidence that two of the alleged victims first revealed their claims of having been molested by Ramos while at a Christian church retreat; in denying a mistrial motion, and not making an inquiry of the jurors following an incident in which one of the alleged victims fainted or fell to the ground as she was exiting the courtroom; and in admitting expert testimony regarding child sexual abuse accommodation syndrome (CSAAS). Ramos also contends a jury instruction pertaining to CSAAS misstated the law. The Attorney General disagrees, and so do we. Thus we affirm. I. VINDICTIVE PROSECUTION Ramos’s first contention is that the prosecution engaged in vindictive prosecution and that the trial court erred in denying a motion seeking relief on this basis. To understand this contention it is necessary to be apprised of the manner in which the counts alleged against Ramos in this case evolved over time. A. Evolution of the Charges 1. The Complaint and the Original Information Ramos was first charged, in December 2022, via a four-count complaint. Thereafter he was charged, in September 2023, via a four-count 2 information (original information). The complaint and the original information each charged Ramos with having committed two offenses against YH; one offense against EM; and one offense against AH. The charges pertaining to YH were forcible sexual penetration of a child under 14 years of age and seven or more years younger than the defendant, in violation of Penal Code section 269, subdivision (a)(5)1 (count 1) and forcible lewd act upon a child under 14 years of age, in violation of section 288, subdivision (b)(1) (count 2). The charge pertaining to EM was the commission of three or more lewd acts upon a child under 14 years of age with whom the defendant resided and to whom the defendant had recurring access, in violation of section 288.5 (count 3); and the charge pertaining to AH (count 4) was for the same type of offense as that charged with respect to EM.2 The complaint and original information also included an allegation that, “in the present case . . . [, Ramos] committed a qualifying sex offense against more than one victim as listed in Penal Code section 667.61, subdivision (e)(4). [15-L, 25-L, LWOP].”3 1 Undesignated statutory references are to the Penal Code.

2 Ramos was not charged in this case with molestation of CH. Evidence of molestation of CH was admitted pursuant to Evidence Code section 1108.

3 The original information (and the amended information, see post) also included particularly-vulnerable-victim enhancement allegations pursuant to rule 4.421(a)(3) of the California Rules of Court—one for YH, one for EM, and one for AH. The jury returned not-true findings as to each of these allegations. We discuss these allegations no further, however, as they are not implicated in the arguments presented on appeal.

3 2. Applicability of the One Strike Law to the Original Charges Penal Code section 667.61, often referred to as the One Strike law, is a provision that mandates imposition of a sentencing enhancement on first- time offenders convicted of committing certain sex offenses4 under aggravating circumstances. The aggravating circumstances are set forth in subdivision (e), and the qualifying offenses are set forth in subdivision (c). Under subdivision (e), the aggravating circumstances include those in which “[t]he defendant has been convicted in the present case . . . of committing an offense specified in subdivision (c) against more than one victim.” This circumstance—known as a multiple-victim-enhancement—was set forth in the version of subdivision (e)(5) of section 667.61 that was in effect during the timeframe during which the molestation of the nieces is alleged to have occurred, and in subdivision (e)(4) of the version of that section that was in effect at the time when the complaint was filed, through and including the present. Then and now, whenever this circumstance would be involved in the commission of a qualifying offense, section 667.61 typically would mandate a sentence of 15 years to life instead of the customary triad.5 (§ 667.61, subd. (b).) During the timeframe in which the complaint and original information were filed (i.e., during 2022 and 2023), qualifying offenses under subdivision 4 We shall hereafter refer to each such offense as a qualifying offense, and to multiple such offenses as qualifying offenses.

5 In most situations in which more than one of the circumstances set forth in section 667.61, subdivision (e), was or is involved in the commission of a qualifying offense, section 667.61 would mandate a sentence of 25 years to life instead of the customary triad. (§ 667.61, subd. (a).) The exceptions to the mandates of section 667.61, subdivisions (a) and (b) are not implicated in the present case.

4 (c) included the offenses set forth in section 288, subdivision (b), (the offense charged in count 2 with respect to YH) and in section 288.5 (the offense charged in counts 3 and 4 with respect to EM and AH). But, during the timeframe in which the molestation of the nieces is alleged to have occurred (i.e., during the period spanning 1999 through 2003), section 288.5 was not a qualifying offense.6 Consequently, interpreting the charges set forth in the complaint and information based on the version of the One Strike law that was in effect at the time when the charges were filed would yield a conclusion that Ramos was exposed to a possible sentence of 15 years to life on each of three of the four counts pleaded, whereas interpreting those same charges based on the version of the One Strike law that was in effect at the time when the offenses allegedly occurred would yield a conclusion that Ramos was exposed to the possibility of such a sentence on just one of the four counts. 3. The Amended Information, Ramos’s Objection to Its Filing, and His Motion Alleging Vindictive Prosecution On May 9, 2024, after voir dire had begun but before jury selection was completed, the People presented the trial court with an amended information. The charges pertaining to YH in the amended information were unchanged from the original information. But the charges pertaining to EM and AH were changed, from one count each (counts 3 and 4 under the original information) alleging a violation of section 288.5, to two counts each (new counts 3 through 6 of the amended information) alleging violations of section 288, subdivision (a). This change was significant in that section 288, subdivision (a)—unlike section 288.5 (see ante)—was a qualifying offense under the One Strike law during the timeframe in which the molestation of 6 Section 288.5 did not become a qualifying offense until September 2006. (Stats. 2006, ch. 337 (Sen. Bill No. 1128), § 33, eff. Sept. 20, 2006.)

5 the nieces is alleged to have occurred. Consequently, Ramos was now exposed to a possible sentence of 15 years to life on each of three counts instead of on just one. Ramos objected to the filing of the amended information. In response to his objection, the People explained the amendment, as follows: “[T]here is no surprise as to what’s been filed. The very charges which were originally filed in the information, Counts 3 and 4, were violations of Penal Code Section 288.5(a), which means that the People have proved or were going to prove up three or more acts of lewd and lascivious conduct on a victim under 14 years old. The People proved that up at [the] preliminary hearing as to both . . . E.M. and A.H., . . . and that means that we proved up at least three or more acts of lewd and lascivious conduct.

“What the People have filed today in the first amended information is simply replacing that charge not with three acts of lewd and lascivious conduct but only two . . .

“Yes, it does change the exposure in that because of the previously alleged multiple victim allegation, this means that then every 288 count upon which the defendant is convicted after he is convicted of a second victim would then change the exposure from a 3-6-8 to now a 15-to-life. But the People had already intended to do that, that is why the multiple victim allegation was alleged in the original complaint. The mistake on the side of the People, which is now corrected by this amended information, is that that multiple victim allegation then may be imposed because it cannot attach to a 288.5 per [the version of] the statute [in effect at the time of the offenses.”

After hearing this explanation, the trial court permitted the amended information to be filed. Explaining its reasoning, the court said: “Essentially the charges haven’t changed[,] only the exposure has changed, and the . . . defense does not dispute that the People have proven up these charges at prelim. And . . . Penal Code 1009 . . . does allow the People to 6 amend their information any time before pleading or a demurrer. So the Court does not find any issue with the amended information. . . . There is no additional victims being added, it’s the same three victims, it’s the same conduct.”

Close in time to the proceedings just discussed, Ramos filed a motion (vindictive prosecution motion), supported by a declaration of his trial counsel, in which he attributed the preparation and filing of the amended complaint to prosecutorial vindictiveness. According to Ramos’s trial counsel: “Mr. Ramos was arraigned on December 16, 2022[,] with identical charges as the information that was filed on September 15, 2023. Both alleged two counts of Penal Code Section 288.5 and zero counts of Penal Code section 288(a).

“Fast forward to May 7, 2024, when the parties were assigned to Department 45 to start trial. Once we arrived in the hallway outside the entry door to Department 45, Defense counsel and [the prosecutor] had a brief conversation about resolution. We discussed a prior offer [that the defense had made on October 3, 2023, and again on April 2, 2024, but that] we did not receive a response to. [The prosecutor] indicated she was rejecting the defense offer. We then informally discussed other possible terms for resolution such as 15- life and 25 years determinate. These discussions were informal and not an offer by either side. No resolution occurred.

“Thereafter, on May 8, 2024, I received an email from [the prosecutor] formally rejecting [our] offer.

“Then on May 9, 2024, I received another email from [the prosecutor], . . . indicating that she [would] be amending the information and adding multiple counts of Penal Code section 288’s to replace the Penal Code section 288.5 allegations.

“[I]f my math is correct, the amendment the Prosecution seeks via [the] amended information, which we have 7 objected to, has increased Mr. Ramos’[s] exposure at least an additional 40 years to life.”

According to Ramos’s trial counsel, there was no justification for the amendment, the prosecution had “lulled the defense into thinking [it] was considering a determinate disposition of the case given the failure to respond to the defense offer from October 3, 2023[,] and April 2, 2024,” and now it was just “punish[ing] and harass[ing]” Ramos and trying to “up the ante” by increasing his exposure to the possibility of a life sentence. In the telling of Ramos’s trial counsel: “The prosecution simply waited for the defense to decide if this case was going to go to trial or resolve. Then when the case resolution fell apart, without explanation or counter-offer, the prosecution decide[d] [to] increase [the] punishment on Mr. Ramos in a retaliatory effort to amend the information.” On this basis, Ramos argued that the prosecution’s conduct in amending the information constituted presumptive and actual vindictive prosecution, warranting either of two proposed remedies. One of the two proposed remedies was that the case “should go to trial on the original charges listed in both the complaint and the [original] information,” rather than on the amended charges. The other proposed remedy was that “the court should not allow the Penal Code section 667.61 allegations to apply to any of the new Penal Code section 288(a) allegations.” The trial court disagreed with the defense. It rejected the argument that vindictiveness should be presumed, and it concluded vindictiveness had not been proven: “In this case the amendments to the information, though [they] upped the ante, did conform to the evidence proved at [the] preliminary hearing. And because vindictiveness is not presumed, [the] defense has to present evidence showing the Prosecutor’s charging decision was motivated 8 by [a] desire to punish the defendant for doing something the law plainly allowed him to do. [T]he Court finds that the defendant failed to present such evidence . . . so the motion for [a] finding of vindictive prosecution is denied.”

B. Trial and Sentencing On May 15, 2024, the day after the trial court had denied the vindictive prosecution motion, the case proceeded to trial. Seven witnesses testified for the prosecution. These were: the four nieces; the mother of two of the nieces (YH and AH); an expert on the topic of CSAAS; and a detective. One witness—Ramos’s ex-wife—testified for the defense. After closing arguments, the jury returned a verdict in which it found Ramos: (1) not guilty on count 1, but guilty of a lesser included offense;7 (2) guilty as charged on counts 2, 5, and 6; and (3) not guilty on counts 3, and 4. In addition, the jury made a true finding on the multiple-victim- enhancement allegation. Thereafter, the trial court sentenced Ramos to a term of imprisonment for a determinate term of seven years on count 1 (the mid-term of what it determined to be the principal count) plus an indeterminate term of 15 years to life on each of counts 2, 5, and 6, for an aggregate term consisting of seven years plus 45 years to life. C. Legal Principles Ramos’s first contention is that that the trial court erred in denying the vindictive prosecution motion and that his convictions on counts 5 and 6 should be reversed for this reason. In examining this contention, we begin with the premise that “the due process clauses of the federal and state 7 The lesser included offense as to which Ramos was found guilty was attempted forcible sexual penetration of a child under 14 years of age and ten or more years younger than the defendant, in violation of sections 664 and 269, subdivision (a)(5).

9 Constitutions (U.S. Const., 5th & 14th Amends.; Cal. Const., art. I, §§ 7, 15) forbid the prosecution from taking certain actions against a criminal defendant, such as increasing the charges, in retaliation for the defendant’s exercise of constitutional rights.” (People v. Jurado (2006) 38 Cal.4th 72, 98 (Jurado).) Indeed, “[t]o punish a person because he has done what the law plainly allows him to do is a due process violation ‘of the most basic sort.’ ” (United States v. Goodwin (1982) 457 U.S. 368, 372 (Goodwin), quoting Bordenkircher v. Hayes, 434 U.S. 357, 363.) A criminal defendant can assert vindictive prosecution in either of two ways: (1) by claiming that a court should apply a presumption of vindictive prosecution (Twiggs v. Superior Court (1983) 34 Cal.3d 360, 371 (Twiggs)); or (2) by proving with evidence that the prosecutor actually had retaliatory motivation. (Goodwin, supra, 457 U.S. at p. 384 [“declining to apply a presumption of vindictiveness . . . do[es] not foreclose the possibility that a defendant in an appropriate case might prove objectively that the prosecutor’s charging decision was motivated by a desire to punish him for doing something that the law plainly allowed him to do” (italics added)].) The standard of review to be applied in examining such an argument is a matter that remains unresolved. (See People v. Ayala (2000) 23 Cal.4th 225, 299 [concluding that trial court’s ruling that there was no evidence of vindictive prosecution was sound “under any standard of review”].) But, as discussed post, we conclude that, irrespective of the standard to be applied, the trial court did not err. D. Analysis Ramos contends (1) that the prosecutor’s conduct in the present case should be presumed to have been vindictive and, in the alternative, (2) that, irrespective of whether that conduct should be presumed to have been 10 vindictive, he has succeeded in proving it actually was vindictive. But neither of these contentions withstands scrutiny. 1. Presumption of Vindictive Prosecution As our Supreme Court has made clear: “In the pretrial setting, there is no presumption of vindictiveness when the prosecution increases the charges or . . . the potential penalty. [Citations.] Rather, the defendant must ‘prove objectively that the prosecutor’s charging decision was motivated by a desire to punish him for doing something the law plainly allowed him to do.’ ” (Jurado, supra, 38 Cal.4th at p. 98.) Here, the conduct complained of occurred “in the pretrial setting” within the meaning of Jurado inasmuch as the jury had not yet been empaneled when the amended information was filed. (Stueve v. Nemer (2017) 7 Cal.App.5th 746, 752 [“it is well settled that a jury trial begins when the jury is impaneled”].) Ramos contends that we should follow the approach of our Supreme Court in Twiggs, supra, 34 Cal.3d at pp. 373–374. He argues that, as in that case, we should analogize the defendant’s situation to that of a defendant in a postconviction context, and therefore presume vindictiveness. But in Twiggs, the increased charges in the amended information were added after a mistrial of the original trial, in which the jury was unable to reach a verdict. Noting that on a retrial, the prosecution “would have a considerable stake in discouraging . . . defendant’s assertion of a retrial, particularly since the prosecution was unable to obtain a conviction in the first trial” (id. at p. 369), the court in Twiggs concluded that any concerns about hampering prosecutorial discretion in a pretrial context did not lead to a conclusion that there was not a realistic likelihood of vindictiveness. (Id. at p. 373). However, because the procedural posture in Twiggs is distinguishable on its facts, we decline to depart from the straightforward application of Jurado. Thus we do not presume vindictiveness.

11 2. Proof of Vindictive Prosecution Turning to the matter of whether Ramos has proven vindictiveness, we begin by noting that Ramos need prove nothing more than that the amendment of the information “was motivated by a desire [on the part of the prosecution] to punish him for doing something that the law plainly allowed him to do.” (Goodwin, supra, 457 U.S. at p. 384.) But the only evidence Ramos submitted to the trial court to prove his claim of vindictiveness was the declaration by his trial counsel recounting the sequence of communications in which he (Ramos’s trial counsel) had endeavored without success to induce the prosecution to either: (1) accept a defense offer to plead guilty to reduced charges or (2) proffer a counter-offer. In none of these communications do we discern, on the part of the prosecution, any interest in accepting or offering a plea to reduced charges. Thus the fact that the plea- related discussions did not result in a guilty plea cannot have been a circumstance that the prosecution would have attributed to Ramos, let alone one that would have triggered a punitive intent.8 Finding no indication that the prosecutor’s decision to amend the information was motivated by a desire to punish Ramos for exercising his right to proceed to trial, we conclude the trial court did not err in denying the vindictive prosecution motion.

8 Ramos asserts on appeal that the prosecution “was fully aware of the fact that the multiple victim allegation did not apply to [the] section 288.5 violation from at least the preliminary hearing,” and he argues on the basis of this assertion that the prosecution was unreasonably dilatory in addressing its mistake. In support of this assertion, he cites a passage from the preliminary hearing; however, we find nothing in this passage that supports the assertion.

12 II. PRIOR DISCLOSURES Ramos’s second and third contentions pertain to testimony about a conversation in which two of the nieces—sisters YH and AH—first told their mother that they had been molested by Ramos. As discussed post, the testimony was that the conversation occurred during a healing retreat at a Christian church. Ramos concedes that testimony about the conversation was admissible in evidence. But he contends testimony about the setting in which the conversation occurred—i.e., an event hosted by a Christian church— should not have been admitted. Specifically, he contends (1) that this testimony was more prejudicial than probative within the meaning of Evidence Code section 3529 and (2) that the testimony’s introduction in evidence violated a restriction, set forth in Evidence Code section 789,10 prohibiting a party from using evidence of a witness’s religious belief to attack or support the witness’s credibility.11 In examining these two contentions, we begin with a pair of motions the parties filed before the trial commenced. A. Motions in Limine, and the Prior Disclosure Doctrine Shortly before the trial commenced, each party filed a motion addressing what is known as the prior disclosure (or fresh complaint)

9 Evidence Code section 352 states: “The court in its discretion may exclude evidence if its probative value is substantially outweighed by the probability that its admission will . . . create substantial danger of undue prejudice, . . .”

10 Evidence Code section 789 states: “Evidence of his religious belief or lack thereof is inadmissible to attack or support the credibility of a witness.”

11 Blending the above-referenced arguments together, Ramos also contends the admission of evidence that the disclosure was made at a Christian Church retreat “violated Evidence Code section 789 and was thus more prejudicial than probative” (italics added).

13 doctrine.12 Pursuant to this doctrine, “proof of an extrajudicial complaint, made by the [alleged] victim of a sexual offense, disclosing the alleged assault, may be admissible for a limited, nonhearsay purpose—namely, to establish the fact of, and the circumstances surrounding, the [alleged] victim’s disclosure of the assault to others—whenever the fact that the disclosure was made and the circumstances under which it was made are relevant to the trier of fact’s determination as to whether the offense occurred.” (People v. Brown (1994) 8 Cal.4th 746, 749−750 (Brown).) Consistent with its nonhearsay purpose, the “doctrine allows evidence to be admitted for the limited purpose of showing that a complaint was made by the victim, and not for the truth of the matter stated.” (People v. Ramirez (2006) 143 Cal.App.4th 1512, 1522.) Thus, “[e]vidence admitted pursuant to th[e] doctrine may be considered by the trier of fact for the purpose of corroborating the victim’s testimony, but not to prove the occurrence of the crime.” (Ibid.) In essence, the prosecution can use such evidence to bolster the credibility of an alleged victim’s testimony that the offense occurred, and the defense can use the absence of such evidence to attack the alleged victim’s credibility. In support of the motion that it filed, the prosecution told the court its witnesses would testify: (1) that, during a highly emotional interaction at a church retreat in 2003 (when AH and YH were teenagers), AH disclosed to her mother, step-father, and sister—YH—that Ramos had molested her; and 12 We agree with our colleagues who decided People v. Flores (2024) 101 Cal.App.5th 438 that, of the different labels that have been attached to the doctrine we are discussing, “prior disclosure” is the most apt. (Id., at p. 443 [“we encourage California courts and commentators to abandon the ‘fresh complaint’ misnomer and refer to this evidentiary rule more accurately as the ‘prior disclosure’ doctrine”].) Hence we use the term “prior disclosure doctrine.”

14 (2) that YH had then revealed to her mother, step-father, and AH in that same conversation that Ramos had molested her as well. The defense, in its motion, objected to the admission of this evidence, arguing (among other things) that the evidence lacked probative value, was highly prejudicial, and would prompt jurors “to think that these people are trustworthy because they go to church.” In support of this argument, the defense cited Evidence Code section 352, but it did not refer to Evidence Code section 789. In considering these motions, the trial court stated: “If I instruct the jury as to the limited purpose for [which] the [prior disclosure] is admitted . . . , then I think the jurors should be trusted with relying on that instruction in terms of what it’s considered for. . .

“In terms of the disclosure being made at church, I don’t think that makes it more prejudicial than probative. The probative value of this information is not substantially outweighed by the danger of undue prejudice.”

Then the court ruled the testimony would be admitted in evidence with a limiting instruction. At trial, AH was the first witness to testify about the prior disclosure and the circumstances surrounding it. Asked by the prosecutor, “do you remember where you were when you told your mother for the first time” about having been molested by Ramos, she replied: “We were at a Christian center.” Then, in response to a short series of questions, AH testified to just two other aspects of the circumstances in which the disclosure to her mother had been made: (1) that her stepfather and sister (YH) had been present at the time; and (2) that YH’s response to the disclosure at the time that AH made the disclosure had made AH sad.

15 After AH’s direct examination ended, Ramos’s counsel cross-examined AH about the circumstances of the disclosure and elicited substantially more detail, as follows: “Q. Now, you said that you had disclosed at some Christian center; correct?

“A. Yes.

“Q. Was this like a retreat?

“A. It was a Christian retreat.

“Q. So there were a lot of people that went to this retreat?

“A. No.

“Q. Can you describe the retreat for us?

“A. We were in a room. It was my mother, my stepfather, my sister [YH], and I.

“Q. And that was all?

“A. Yes.

“Q. And prior to going into this room, what were you guys doing?

“A. I don’t remember.

“Q. Was there, like, a church service?

“A. Yes, but we were in that room.

“Q. And during the church service were there people crying?

“A. I don’t recall.

“Q. Prior to you disclosing, was it an emotional retreat?

“A. No.

16 “Q. Did you feel like you had to talk about something at this retreat?

“A. Yes.

“Q. Felt like you had to disclose something personal during this retreat?

“A. Yes.

“Q. In that room, did your parents disclose anything personal to you prior to you disclosing?

“A. No.

“Q. So you’re at the Christian retreat, you guys are in a room, and all of a sudden you just disclose; is that accurate?

“A. Yes.

“Q. Is this Christian center, is this local to your home or something you had to drive to, walk to, or something different?

“A. We would have to travel all the way over there.

“Q. So it’s not something that you go to once a week?

“A. No.

“Q. Was it, like, a one time kind of retreat?

“A. Yes.”

Thereafter AH’s sister, YH, testified about her disclosure. In response to questions posed by the prosecution, YH testified that she had disclosed the abuse to her mother “at a church event.” Then, during the remainder of her direct examination and during her cross-examination, AH revealed just three other aspects of the circumstances in which she had made her disclosure. These were: (1) that she had been 13 or 14 years old at the time; (2) that she 17 did not recall having disclosed the molestation to anyone before that time; and (3) that it was at that time that she first learned Ramos had also molested AH. Immediately after YH finished testifying, her mother took the stand; and the trial court, pursuant to an agreement of the parties, gave the jury this limiting instruction: “Evidence will be received that on an occasion outside of court, [YH and AH] made a complaint of sexual misconduct relating to the charges before you. You may consider such evidence solely for the purpose that a complaint was made and not as proof of the truth of the content of the alleged victims’ complaints.”

Then, under questioning by the prosecutor, the mother briefly described the retreat and, at more length, the conversation in which the disclosures had occurred. She said that, immediately before AH told her she had been molested by Ramos, she and AH had been arguing: “A. We were talking and [I was] asking why she was [behaving the way she was]. . . We were . . . arguing, and she told me, ‘You don’t understand me. You don’t know what I’ve been through.’

“[¶ . . . ¶]

“Q. [W]ould you describe the situation as tense . . . ?

“A. Yes. Yes.

“Q. When you were asking her why she was [behaving the way she was], can you describe how she was like?

“A. She was crying very hard.

“Q. Now, at that moment, did she respond to you?

“A. [S]he said, ‘You don’t know what has happened to me. You don’t know what has happened to me.’

18 “[¶ . . . ¶]

“A. She was crying and crying a lot of tears.

“Q. Was she speaking loudly or softly?

“A. Very loud.

“Q. Did she say anything beyond that?

“A. Yes.

“Q. In just a general term, so not all the details, did she make a disclosure, yes or no?

“A. Yes.

“Q. Did she say who it involved?

“A. Yes.”

Then, after testifying about AH’s disclosure of sexual abuse by her uncle, the mother proceeded to testify about YH’s disclosure: “Q. Now, when [AH] disclosed this to you, did something else happen in response?

“A. Yes.

“Q. What did you see happen?

“A. [YH] and [AH] looked at each other, and they said, ‘Did he do the same things to you?’

“[¶ . . . ¶]

“Q. Now, when you saw [YH] say these words to [AH], can you describe how she looked when she said this?

“A. Yes, she was surprised.

“Q. Can you describe how [AH] looked after [YH] said this to [AH]?

19 “A. She was also surprised, like, ‘Did that happen to you too?’ ”

Then the mother testified about YH’s disclosure of sexual abuse by her uncle. Thereafter, under questioning by Ramos’s counsel, the mother supplied a description of the overall dynamic of the retreat preceding the conversation about which AH, YH, and their mother had testified: “Q. Guadalajara, is that where the retreat was?

“A. Yes.

“Q. What was this retreat all about?

“A. [AH] was always very emotional. We would always see her very sad.

“Q. But what was the retreat about?

“A. To heal emotions.

“Q. And you knew that going to the retreat?

“A. Yes.

“Q. And when you got to the retreat, were there a lot of people there?

“A. No, just the individuals that would live at that house. It was a house.

“Q. Okay. And how many people were in the house?

“A. I don’t know. . . I would say about ten people.

“Q. So were there any other people that came to the retreat with their children?

“A. Yes.

“Q. How many of those people were there?

20 “A. It was like six teenagers.

“Q. All in the same house?

“A. Yes. Yes.

“Q. And were there group meetings?

“A. That is correct.

“Q. Group meetings for everyone to heal?

“A. Well, yes. Yes.

“Q. The pastors talking to everyone, right?

“A. It’s a female pastor, yes.

“Q. She’s talking to everyone as a group, correct?

“A. Yes.

“Q. Talking about healing, correct?

“A. That is correct.

“Q. And I’m sure throughout the time people are crying, correct?

“A. Yes.

“Q. Trying to heal, correct?

“A. That is correct.

“Q. Talking about their issues, correct?

“A. No. No, they don’t talk.

“Q. They just cry?

“A. They just pray.

“Q. But they cry as well, correct?

“A. Of course.

21 “Q. And this is all before any of your daughters said anything to you, correct?

“A. Well, yes. We were coming from that praying.

“Q. You were coming from one of the praying sessions when your daughters disclosed to you; is that correct?

“A. Yes.

“[¶ . . . ¶]

“Q. And . . . you had said that . . . [AH] was arguing; is that correct?

“A. I would ask her[:] [‘W]hy are you like this? Why are you so quiet and not say anything[?’]

“Q. And that was what you meant by arguing?

“A. Uh-huh.

“Q. What triggered that argument while you were at the retreat?

“A. I raised my voice and I told her[:] [‘W]hy are you like this? Why?[’]

“Q. And that’s when she responded [‘]you don’t understand;[’] is that correct?

“A. [‘]You don[’]t understand me.[’]

“Q. And that’s what you were referring to when you said you guys were fighting; correct?

“A. Uh-huh, we were arguing.”

Later during the trial, after all of the witnesses had testified, the trial court engaged counsel for both parties in a discussion about prospective jury instructions. One such instruction pertained to the testimony about the retreat. The discussion about this instruction proceeded as follows:

22 “The Court: The next [prospective instruction] is the [prior disclosure] special instruction that was requested by the defense. [For ] [t]his one I added in more specific information . . . [I]t made sense to be broad when [we were] reading it right before the testimony of [the mother. But,] now that it’s being read [ ]together [with the other jury instructions] at the end of the entire case, if it just reads ‘on an occasion outside of court, the alleged victims made complaints of sexual misconduct relating to charges before you to their mother,’ and it says, ‘you may consider such evidence solely for the purpose that a complaint was made[,]’ . . . that might confuse the jurors without specifying what outside of the court occasion that it actually was[,] because they made complaints of their alleged abuse more than just at the church retreat. [¶] Any comments or objection?

“[Prosecutor]: People submit.

“[Defense counsel]: One moment, your Honor. Submit, your Honor.

“The Court: Okay. Thank you. So this one will be read [as], ‘[E]vidence was received that[,] on an occasion outside of court, at a church retreat, . . . [AH] and [YH] made complaints of sexual misconduct relating to the charges before you to their mother [mother identified by name]. You may consider such evidence solely for the purpose that a complaint was made and not as proof of the truth of the contents of the alleged victims[’] complaint.”

Neither party objected, and the court thereafter instructed the jury using the words it had added: “at a church retreat.” B. Analysis As mentioned ante, Ramos contends the trial court erred in admitting the testimony that the setting in which the prior disclosures by AH and YH had been made was a Christian church retreat, and that such evidence should have been excluded pursuant to Evidence Code sections 352 and 789. In making this argument, he emphasizes that the testimony in issue was not 23 just that the disclosures had occurred at a church retreat, but that they had occurred at a Christian retreat. We review evidentiary rulings for an abuse of discretion. (Flores, supra, 101 Cal.App.5th at p. 449.) “A court abuses its discretion only when” the decision it makes is “ ‘ “ ‘an arbitrary, capricious, or patently absurd determination.’ ” ’ ” (In re Caden C. (2021) 11 Cal.5th 614, 641 (Caden C.)). As a consequence, “ ‘ “ ‘[w]hen two or more inferences can reasonably be deduced from the facts, the reviewing court has no authority to substitute its decision for that of the trial court,’ ” ’ ” (ibid.) and it “should interfere only ‘ “if . . . under all the evidence, viewed most favorably in support of the trial court’s action, no judge could reasonably have made the order that he [or she] did.” ’ ” (In re Robert L. (1993) 21 Cal.App.4th 1057, 1067.) Applying this standard, we begin by noting that the challenged evidence is clearly relevant. As the defense acknowledges in its briefs, “this case was almost entirely dependent on the relative credibility of the complaining witnesses.” And, as explained ante, when the credibility of a complaining witness in a molestation case has been placed in issue, evidence of a prior disclosure may be used to bolster the credibility of that witness’s assertion that an offense in fact occurred. The admissibility of such evidence is not confined to just the fact that the alleged victim disclosed the molestation to others. (Brown, supra, 8 Cal.4th at pp. 749–750, 761–763.) Rather, it extends to the circumstances surrounding the disclosure (ibid., italics added), including such surrounding circumstances that would tend to corroborate the testimony that prior disclosures had indeed occurred. In this case, that included evidence that the disclosures had been made in a context in which the spilling of highly personal closely held secrets would be 24 plausible—specifically, the emotionally charged crucible of a prayerful emotional healing retreat. With respect to Evidence Code section 352, we see little if any prejudice arising from the mere fact of the jury having heard testimony that the retreat at which the disclosures occurred was an event hosted by a church. As for the testimony that it was a Christian church, we note that this detail surfaced in the first instance in an answer given by a witness rather than in a question posed by the prosecution; that there is no indication in the record that the defense objected to the retreat (or the retreat center) being characterized as Christian;13 that, to the contrary, Ramos’s counsel used the terms “Christian center,” “Christian retreat,” and “pastors” in questioning AH about the retreat; that the prosecution did not treat this detail as a rallying point in its questioning of the witnesses;14 and that, given the location—Guadalajara, Mexico—in which the jury was told the retreat occurred, it is likely that individuals serving on a jury in southern California would in any event have understood the words “church retreat” to most likely be reference to a Christian church retreat.

13 Ramos cites polling data and an article from the Journal for the Scientific Study of Religion to support an argument that a “reference to participating in a Christian church retreat can conjure up an impression of trustworthiness.” But we do not consider these items, as they were not presented to the trial court and do not appear in the record on appeal. (Innovative Business Partnerships, Inc. v. Inland Counties Regional Center, Inc. (2011) 194 Cal.App.4th 623, [“In the absence of exceptional circumstances, the appellate court does not consider evidence that was not presented to the trial court.”].)

14 Indeed the defense focused substantially more attention on the details of the retreat than the prosecution did.

25 Moreover, to the extent that the witnesses’ testimony about the setting in which the disclosures occurred might have entailed any prejudice (let alone “undue” prejudice that could “outweigh[ ]” the probative value of the evidence, and do so by a “substantial[ ]” margin (Evid. Code, § 352)), the risk attending any such prejudice would have been more than adequately contained by the twice-repeated limiting instruction that the trial court gave at Ramos’s request (see People v. Stayner (2026) 19 Cal.5th 395, 531 (Stayner) [“[j]urors are presumed to follow the court’s instructions”]; People v. Ghebretensae (2013) 222 Cal.App.4th 741, 755 (Ghebretensae) [rejecting as “pure speculation” “any suggestion . . . that the jury was likely to have disregarded [a limiting] instruction”]) and to which Ramos’s counsel acquiesced even after the court had proposed adding the words “at a church retreat” to it. As for the contention that the testimony about the setting in which the disclosures occurred ran afoul of Evidence Code section 789,15 we find no indication in the record to suggest that any of the references to a church or to Christianity was intended to do what section 789 proscribes, which is “to attack or support the credibility of a witness.” Instead, they appear to have been intended for the purpose of providing context, by shedding light on the circumstances surrounding AH and YH’s earlier disclosures, which is precisely the type of evidence that the prior disclosure doctrine permits trial courts to admit. Hence we conclude that the trial court’s admission of this 15 The Attorney General contends Ramos forfeited any contention based on Evidence Code section 789 because his trial counsel failed to specify section 789 when he objected to the admission of the prior disclosure evidence; however, we conclude Ramos’s trial counsel sufficiently invoked section 789 when he argued in the trial court (see ante) that evidence to the effect that the prior disclosures had occurred in the setting of a church retreat would prompt jurors “to think that [the witnesses] are trustworthy because they go to church.”

26 evidence was not arbitrary, capricious, or patently absurd. (Caden C., supra, 11 Cal.5th at p. 641) and thus was not an abuse of discretion. III. FAINTING INCIDENT Ramos’s fourth contention is that the trial court abused its discretion in denying a mistrial motion, and in not making an inquiry of the jurors, following an incident in which YH, during a break in her testimony, fainted or fell to the ground in a doorway leading from the courtroom to a hallway. A. Additional Background The fall occurred during a recess in the proceedings. Immediately prior to the recess, the prosecutor had been asking YH about the ways in which Ramos had touched her vagina, and YH had been crying on the witness stand. After the trial court called the recess, the jurors exited through a courtroom doorway into a hallway. YH followed them, but fainted or fell to the ground in the doorway. As reported by defense counsel: “The jury had just exited [when] we were informed in the back that she may be getting sick. She followed, I would say almost immediately after the jury exited the courtroom. She ended up exiting the courtroom and it looked like she fell at the doorway. I don’t know what she fell on, if she passed out or anything of that nature, I just know she fell. She was crying on the floor and I know that jurors were still out there and still in the hallway.”

Within a minute or two, YH stood back up. Before the jury returned, defense counsel asked the court to declare a mistrial on the grounds that “Mr. Ramos is going to be . . . highly prejudiced to the point where he will be denied a fair trial given the jury was [present] when this occurred.” The trial court responded by saying: “I don’t think there [are] grounds for it. Witnesses act emotionally on the stand, their demeanor is part of what should be on the record, their response to certain 27 testimony, events, is a natural part of what happens in the court proceedings.”

Then, after hearing from the prosecution, the trial court said, “I am denying the request for a mistrial.” Defense counsel thereafter renewed his argument, stating (among other things): “I want to be clear it wasn’t during her testimony that she either had some emotional issue or health issue, but it was during a break and it was in front of the jury, and it does prejudice my client. [I]t garners sympathy for the victim, outside of courtroom proceedings, that significantly prejudices my client. Other than that, I don’t have anything else to add.”

Unpersuaded by the additional argument, the trial court responded: “I’m still denying the request for a mistrial.” Thereafter, the trial court inquired as to whether counsel desired that a curative instruction be given to the jury. In the course of making this inquiry, it suggested language borrowed from a passage of CALCRIM No. 222 and asked counsel if they believed something more might be needed. Defense counsel did not request alternative language and instead responded: “I would like it to be read.” Then, when the jury returned to the courtroom, the court instructed the jury, in keeping with the CALCRIM No. 222 language that it had suggested (and that defense counsel had requested), as follows: “[Y]ou must disregard anything that was seen, anything you saw or heard when the court was not in session, even if was done or said by one of the parties or witnesses.” B. Analysis As noted ante, Ramos’s argument with respect to the incident in which YH fainted in the hallway includes two components. The first component is an argument that the trial court abused its discretion in denying Ramos’s mistrial motion. The second component is an argument that it abused its 28 discretion in not inquiring of the jurors with respect to the incident on which the motion was predicated. Addressing the second component first, we note that Ramos did not ask the trial court to make an inquiry of the jurors. Hence this component of his argument is forfeited. (People v. Ramirez (2006) 39 Cal.4th 398, 460 [defendant who filed motion for a mistrial, but did not ask trial court to inquire of jurors, as to out-of-court occurrences forfeited argument that trial court should have made inquiry of jurors].) Although Ramos contends he had no opportunity to request an inquiry be made of the jurors before the court denied his motion, we conclude the record indicates otherwise. The trial court twice afforded the defense an opportunity to argue for a mistrial. But, even after having been placed on notice that the court was disinclined to grant the motion, and after having been afforded an opportunity to argue the matter further, the defense did not request that the trial court inquire of the jurors. Turning to the other component of Ramos’s argument (that in which he argues that it was an abuse of discretion for the trial court to deny the motion for a mistrial), we cannot conclude that the court’s decision to deny a mistrial was arbitrary, capricious, or patently absurd. (Caden C., supra, 11 Cal.5th at p. 641.) As discussed ante, the court heard arguments from both the defense and the prosecution before denying the mistrial motion. It suggested a curative instruction, offered the defense an opportunity to weigh in, and, at the defense’s request, gave the jury such an instruction. Finding no indication in the record to the contrary, we presume the jurors followed the instruction. (Stayner, supra, 19 Cal.5th at p. 531; Ghebretensae, supra, 222 Cal.App.4th at p. 755.) Moreover, the jury’s decision to acquit Ramos on one of the two counts with which he was charged as to YH, and its election to 29 convict him instead of a lesser included offense, tends to reinforce a conclusion that the jury’s judgment was not unduly influenced by sympathy for YH. IV. CSAAS Ramos’s final two contentions relate to CSAAS. One of these contentions is that the trial court abused its discretion in admitting expert testimony regarding CSAAS. The other contention is that the trial court erred in using CALCRIM No. 1193 to instruct the jury on CSAAS. In examining these two contentions, we commence with a brief introduction to CSAAS and the role of expert testimony pertaining to CSAAS in criminal trials in California. A. Legal Principles CSAAS is a term used to describe certain behaviors commonly observed in children who are assumed to have been sexually abused. (See, e.g., People v. Page (2025) 114 Cal.App.5th 1022, 1028, fn. 2 (Page); In re Amber B. (1987) 191 Cal.App.3d 682, 690, fn. 3; People v. Munch (2020) 52 Cal.App.5th 464, 470 (Munch).) Thirty-five years ago, in People v. McAlpin (1991) 53 Cal.3d 1289 (McAlpin), our Supreme Court held that expert testimony on CSAAS “is not admissible to prove that the complaining witness has in fact been sexually abused,” but that it nonetheless “is admissible to rehabilitate such witness’s credibility when the defendant suggests that the child’s conduct after the incident—e.g., a delay in reporting—is inconsistent with his or her testimony claiming molestation.” (Id. at p. 1300, italics added, citing People v. Bowker (1988) 203 Cal.App.3d 385, 390–394 (Bowker), People v. Gray (1986) 187 Cal.App.3d 213, 217–220, and People v. Roscoe (1985) 168 Cal.App.3d 1093, 1097–1100; see also Page, supra, 114 Cal.App.5th at p. 1028 [expert testimony on CSAAS is admissible “to explain the child’s apparently self- 30 impeaching behavior” in instances in which “ ‘credibility is placed in issue due to [the seemingly] paradoxical behavior . . . [of a child’s] delay in reporting a molestation,’ ” quoting in part People v. Patino (1994) 26 Cal.App.4th 1737, 1744-1745.) Indeed, our high court said not only that such expert testimony may be permissible, but that it is “ ‘needed to disabuse jurors of commonly held misconceptions about child sexual abuse, and to explain the emotional antecedents of abused children’s seemingly self- impeaching behavior.’ ” (McAlpin, supra, at p. 1301, italics added). In order for expert testimony regarding CSAAS to be admitted at trial, it “must be targeted to a specific ‘myth’ or ‘misconception’ suggested by the evidence.”16 (Bowker, supra, 203 Cal.App.3d at p. 394.) Thus, “[f]or instance, where a child delays a significant period of time before reporting an incident or pattern of abuse, an expert could testify that such delayed reporting is not inconsistent with the secretive environment often created by an abuser who occupies a position of trust.” (Ibid.; see also Couzens & 16 Courts not infrequently speak of CSAAS evidence as being admissible to counter a “myth” harbored by laypersons. (See, e.g., Bowker, supra, 203 Cal.App.3d at pp. 393–394 [CSAAS “evidence must be targeted to a specific ‘myth’ or ‘misconception’ [about child sexual abuse] suggested by the evidence”].) Often, the “myth” is that a child who has been sexually abused reports the abuse promptly. In our view, the term “myth” in this context is not particularly helpful. Defense counsel routinely challenge the credibility of alleged victims of all manner of criminal offenses—not just alleged victims of child sexual abuse—by focusing on evidence that the alleged victim delayed in reporting, or initially played down the importance of, an act constituting an element of the charged offense. To the extent a person believes that a child will report sexual abuse promptly, it probably is because such person believes that a victim of most any offense will report the crime promptly; and that is not a “myth.” Expert testimony pertaining to CSAAS is intended to explain to the jury certain dynamics that have been observed in situations involving the sexual abuse of a child by an offender with whom the child has a relationship, not to debunk some so-called “myth” that is unique to victims of child sexual abuse.)

31 Bigelow, Cal. Practice Guide: California Law and Procedure (The Rutter Group 2025) [“The expert testimony is admissible to rehabilitate a victim’s credibility, for example, when the defendant suggests that the child’s delay in reporting is inconsistent with his or her testimony claiming molestation”; citing cases].) With this introduction to CSAAS, we now turn to proceedings in this case that bear on the arguments presented by Ramos. B. Additional Background 1. The Motions in Limine Pertaining to CSAAS, and the Instruction Given to the Jury Prior to the Testimony of Dr. Jody Ward Prior to trial, each party filed a motion in limine pertaining to CSAAS. In its motion, the prosecution requested that expert testimony pertaining to CSAAS be admitted. The defense requested that such testimony be excluded. During a pre-trial hearing on the motions, the trial court ruled that (subject to certain limitations) CSAAS testimony could be admitted in evidence. Then, after the four nieces and the mother of YH and AH had testified, the prosecution informed the trial court of its intention to call to the witness stand its CSAAS expert, psychologist Dr. Jody Ward. In response to a request by the defense, the trial court decided that it would give the jury an instruction on CSAAS, not only after the close of all of the evidence, but also immediately before Dr. Ward’s testimony. In arguments pertaining to this topic, the defense proposed that the CSAAS instruction be modeled on CALJIC No. 10.64, and the prosecution proposed that it instead be modeled on CALCRIM No. 1193. The trial court decided to model its CSAAS instruction on CALCRIM No. 1193, but it acceded to a defense request that it 32 replace the words “consistent with” in that pattern jury instruction with the words “not inconsistent with.”17 Thus, immediately prior to the testimony of the prosecution’s expert on CSAAS, the trial court instructed the jury—in keeping with CALCRIM No. 1193—as follows: “You will hear testimony from Dr. Jody Ward regarding Child Sexual Abuse Accommodation Syndrome. Child Sexual Abuse Accommodation Syndrome relates to a pattern of behavior that may be present in child sexual abuse cases. Testimony as to the accommodation syndrome is offered only to explain certain behaviors of an alleged victim of child sexual abuse. Dr. Jody Ward’s testimony about Child Sexual Abuse Accommodation Syndrome is not evidence that the defendant committed any of the charged−—of the crimes charged against him or any conduct with which he was not charged. You may consider this evidence only in deciding whether or not the alleged victim’s conduct was not inconsistent with the conduct of someone who has been molested and in evaluating the believability of the alleged victims.”

2. Dr. Ward’s Testimony Dr. Ward testified that she was a clinical and forensic psychologist whose practice is geared toward sexual offending and sexual abuse. She told the jury that that she had not interviewed any witnesses or reviewed police reports in this case, that she had no knowledge of the particular facts of the case, and that she was not present to opine as to whether Ramos had committed the alleged crimes or as to whether the victims were telling the truth. Instead she said she was there “to talk about . . . a pattern of 17 The “not inconsistent with” phraseology derived from a predecessor version of CALCRIM No. 1193 (see Page, supra, 114 Cal.App.5th at pp. 1031–1033; see also id., at p. 1035 (conc. opn. of Kelety, J.)) and from CALJIC No. 10.64.

33 behaviors that many children exhibit who have been sexually abused within an ongoing relationship”—i.e., CSAAS. Dr. Ward explained that evidence of behaviors associated with CSAAS “can’t be used to look back and determine or diagnose whether or not sexual abuse [actually] occurred,” but that, in instances in which a child is known to have been sexually abused, the “behaviors [associated with CSAAS] are helpful to understand the child’s reactions to that abuse.” According to Dr. Ward, “[c]hildren who have been abused within an ongoing relationship respond very differently than . . . children who are abused once by a stranger.” Specifically, “children who . . . have been abused once by a stranger tend to report that abuse right away because they have no relationship to that person who abused them,” and they “tend to be believed.” By contrast, “children who have been abused within an ongoing relationship . . . don’t tend to report the abuse right away” (italics added) due to feelings of “love and loyalty toward the abuser”; and, “[w]hen they do report the abuse, . . . they [often] are not believed.” Dr. Ward further testified that CSAAS is comprised of five components: “secrecy, helplessness, entrapment and accommodation, delayed/unconvincing disclosure, and retraction or recantation.” She then described each of the five components, as follows: The first component of CSAAS, secrecy, refers both to the fact that sexual abuse typically “occurs in secret with only the victim and the perpetrator there at the time the sexual acts are occurring,” and to the fact that, for various reasons, children often do not disclose sexual abuse for “many, many years.” Some of the reasons children maintain such secrecy are that they have been asked to keep the activity secret, they find the activity 34 “embarrassing,” or they fear that disclosing the activity will negatively affect the family. CSAAS’s second component, helplessness, “refers to the power imbalance between adults and children.” Due to this imbalance, children who are experiencing sexual abuse often “don’t have the avenues at their disposal that we have as adults to get out of the situation.” The third component of CSAAS, entrapment and accommodation, refers to the fact that abused children “become entrapped and . . . have to learn other ways to cope with the ongoing sexual abuse,” such as, for example, acquiescence, accommodation, or compartmentalization. “[G]oing back to secrecy[,] [b]ecause children don’t tend to report the abuse right away, the perpetrator can go back to that child for more and more sexual abuse over a period of time. And because of the helplessness . . . , children can’t escape this situation. They become entrapped and they have to learn other ways to cope with the ongoing sexual abuse. So children may cope or accommodate the sexual abuse by acquiescing, by going along with it, by believing that I have to put up with this very negative aspect of sexual abuse in order to receive what is positive in the relationship. This can be provision of material needs or, more importantly, emotional needs. Children may believe that they have to put [up] with the sexual abuse so that other siblings or other children are not sexual[ly] abused. Children may accommodate the abuse by walling it off in the memory and compartmentalizing it and putting it aside and trying to forget about it.

“[T]he most important thing to keep in mind about that accommodation phase is that to those of us on the outside looking in all we see is the very negative aspect of sexual abuse and we think[,] ‘if this was happening to me[,] I would do everything I could in the situation to get out of that.’ But for children it’s not the same. Children don’t think the same way because of the helplessness involved. So this otherwise very positive relationship with a very 35 negative sexual aspect going on is very confusing to children.”

CSAAS’s fourth component, delayed disclosure, refers to the fact that “[m]ost of the time children wait until adulthood to report . . . sexual abuse.” “[C]hildren are very adept at knowing how their mother or other adults close to them are going to respond if a child makes a disclosure of sexual abuse. So, for instance, if sexual abuse is occurring outside the home and the child knows the father will overreact and get a shotgun and try to shoot that person and then end up in jail himself, that child will not report it to that person because the child is afraid of what will happen when they make the disclosure. The same may be true for . . . a mother or any other person in the home. If the child believes that that person won’t be supportive for whatever reason then the child doesn’t tend to report sexual abuse to that person.”

The fifth component, retraction or recantation, refers to the fact that, “[o]nce a child has made a disclosure of sexual abuse, that child’s life is turned completely upside down,” which may cause some to “minimize” or cast doubt on their allegations of abuse or “completely recant [such] allegations altogether.” Dr. Ward testified that the first two components are present in all situations involving sexual abuse of children. The third, fourth, and fifth components, alone or in combination, may or may not be present in a given situation. 3. The CSAAS Instruction Given to the Jury After the Testimony of Dr. Ward After the prosecution and defense had rested their cases and before closing arguments commenced, the trial court gave the jury its pre- deliberation instructions. On the topic of CSAAS, it instructed the jury in a manner that was in essence identical to the manner (see ante) in which it had instructed the jury immediately prior to Dr. Ward’s testimony.

36 C. Analysis 1. Admission of CSAAS Evidence As noted ante, Ramos contends the trial court abused its discretion in admitting expert testimony about CSAAS. In support of this contention, he argues: (1) “that the prosecution failed to establish as a foundational matter that the jury harbored misconceptions about the behavioral patterns of child victims of sexual abuse”; (2) “that[,] regardless of whether the prosecution had the burden to prove th[at] myths or misconceptions surrounding sexual abuse of children still exist, expert testimony was not needed to disabuse the jury of myths or misconceptions”; and (3) that the probative value of the CSAAS evidence in this case was substantially outweighed by the risk of prejudice. We examine each of these three arguments in turn. So doing, we review the trial court’s decision to admit Dr. Ward’s evidence for an abuse of discretion. (People v. Garcia (2025) 115 Cal.App.5th 92, 110; McAlpin, supra, 53 Cal.3d at p. 1299 [“the decision of a trial court to admit expert testimony ‘will not be disturbed on appeal unless a manifest abuse of discretion is shown’ ”].) Focusing first on Ramos’s argument that Dr. Ward’s CSAAS testimony was inadmissible because “the prosecution failed to show that the jury harbored misconceptions about the behavioral patterns of child victims of sexual abuse,” we observe that this is a variation of an argument that was thoroughly examined—and decisively rejected— just six years ago by the Second District Court of Appeal in Munch, supra, 52 Cal.App.5th 464. In that case, the defense argued that “ ‘the public no longer holds the presumed misconceptions [that CSAAS] testimony purports to address.’ ” (Id., at p. 468.) Stated differently, the defense argued in essence that “McAlpin is out of date.” (Id., at p. 466.) On this basis, it “invite[d] [the court of appeal] to no longer follow McAlpin.” (Id., at p. 468.)

37 In response to this invitation, the court of appeal reviewed three decades’ worth of California jurisprudence in which “courts ha[d] long recognized the well-established relevance, necessity, reliability, and importance of [CSAAS] evidence.” (Munch, supra, 52 Cal.App.5th at p. 472.) In addition, the court surveyed published opinions from numerous other jurisdictions throughout the country, together with several law review articles and additional scholarship on the topic of CSAAS. (Id., at pp. 469– 472.) On the basis of this examination, the court concluded that “CSAAS evidence [remained] a valid and necessary component of the prosecution case in matters involving child abuse,” (id., at p. 466) that “the vast majority of jurisdictions . . . have rendered decisions that are consistent with McAlpin,” (id., at p. 472) and that “the reasoning of McAlpin is as valid today as it was in 1991.” (Id., at p. 466.) The court also pointed out that, McAlpin being a Supreme Court opinion, it “is binding on all lower courts in this state.” (Id., at p. 468.) Based on the reasoning set forth in Munch, we conclude there was no need for the prosecution in this case to establish that the jury (or the general public) harbored misconceptions about the behavioral patterns of child victims of sexual abuse, because the existence of those misconceptions was already recognized by the case law. Turning to Ramos’s argument that “expert testimony was not needed to disabuse the jury of myths or misconceptions,” we begin by observing that it is a normal part of litigation for a defense to be premised at least in part on a claim that the complaining witness lacks credibility and to focus on evidence of the witness’s failure to timely disclose an act constituting an element of the charged offense. As Dr. Ward explained, the disclosure dynamic observed in children who have been sexually abused is quite different than that associated with most other types of crime victims; and, without evidence of 38 that unique dynamic, the jury might be led astray by evidence of behavior that, in many other types of cases, would support a credibility challenge. Further, the concept of “need” in the context of admitting expert opinion at trial is relative. As our Supreme Court stated in McAlpin: “ ‘[T]he admissibility of expert opinion is a question of degree. The jury need not be wholly ignorant of the subject matter of the opinion in order to justify its admission; if that were the test, little expert opinion testimony would ever be heard. Instead, [Evidence Code section 801] declares that even if the jury has some knowledge of the matter, expert opinion may be admitted whenever it would “assist” the jury. It will be excluded only when it would add nothing at all to the jury’s common fund of information, i.e., when “the subject of inquiry is one of such common knowledge that men of ordinary education could reach a conclusion as intelligently as the witness.” ’ ” (McAlpin, supra, 53 Cal.3d at pp. 1299–1300.)

While it certainly is possible that members of the public who serve as jurors have some understanding of the sorts of behavioral dynamics to which Dr. Ward testified, they do not necessarily appreciate the complexities of child psychology and how a child’s relationship with their abuser might impact the child’s response to the abuse. Moreover, to the extent that some jurors might have some understanding of this psychology, the expert testimony remains admissible so long as it would generally assist the jury as a whole. (See McAlpin, supra, 53 Cal.3d at pp. 1299–1300.) Consequently, the trial court’s conclusion that Dr. Ward’s testimony would be of assistance to the jury to at least some extent cannot reasonably be said to have been arbitrary, capricious, or patently absurd. (Caden C., supra, 11 Cal.5th at p. 641.) As for the argument that the probative value of Dr. Ward’s testimony was substantially outweighed by the risk of prejudice, we again cannot agree 39 that the trial court’s conclusion to the contrary was arbitrary, capricious, or patently absurd. For reasons stated ante, the testimony was clearly probative. As for prejudice, Dr. Ward made clear in her testimony that she was not in a position to opine as to whether the nieces “ha[d] in fact been sexually abused.” (See McAlpin, supra, 53 Cal.3d at p. 1300 [CSAAS “is not admissible to prove that the complaining witness has in fact been sexually abused”].) Moreover, consistent with McAlpin, the trial court twice instructed the jury that Dr. Ward’s testimony was “not evidence that the defendant committed any . . . of the crimes charged against him or any conduct with which he was not charged” and could be considered only for the limited purpose of deciding whether the nieces’ conduct was not inconsistent with the conduct of someone who has been molested and evaluating the nieces’ credibility. (See ante; see also Stayner, supra, 19 Cal.5th at p. 531 [“[j]urors are presumed to follow the court’s instructions”].) Under these circumstances, any prejudice attending Dr. Ward’s testimony was not “undue” and did not “outweigh[ ],” let alone “substantially outweigh[ ],” (Evid. Code, § 352) the testimony’s probative value. For these reasons, we conclude the trial court did not err in admitting Dr. Ward’s testimony regarding CSAAS. 2. CALCRIM No. 1193 Ramos’s final contention is that the trial court erred in modeling its CSAAS instruction on CALCRIM No. 1193. The basis for this contention is an argument that CALCRIM No. 1193 misstates the law. Specifically, Ramos argues that: “CALCRIM [No.] 1193 directs the jury to consider expert testimony on CSAAS, not only to determine whether the complaining witness’s testimony is not inconsistent with having been molested, but also to evaluate the believability 40 of the complaining witness’s testimony. [But] [t]he believability of the complaining witness’s testimony is indistinguishable from the truth of the charge. Thus, CALCRIM [No.] 1193 is improper.”

In making this argument, Ramos is treading ground well-trod.18 (See, e.g., Page, supra, 114 Cal.App.5th at pp. 1029–1030 [“We are not the first appellate court to reject the argument that CALCRIM No. 1193 impermissibly permits jurors to consider CSAAS testimony as evidence of guilt.”]; People v. Ramirez (2023) 98 Cal.App.5th 175, 219-220; People v. Ortiz (2023) 96 Cal.App.5th 768, 815-816 (Ortiz); Munch, supra, 52 Cal.App.5th at pp. 473-474; People v. Lapenias (2021) 67 Cal.App.5th 162, 175-176 (Lapenias); People v. Gonzales (2023) 16 Cal.App.5th 494, 503-504 (Gonzales).) As these courts have concluded: “ ‘A reasonable juror would understand CALCRIM No. 1193 to mean that the jury can use [the expert’s] testimony to conclude that [the victim’s] behavior does not mean she lied when she said she was abused. The jury also would understand it cannot use [the expert’s] testimony to conclude [the victim] was, in fact, molested. . . . Thus, under CALCRIM No. 1193, a juror who believes [the expert’s] testimony will find both that [the victim’s] apparently self-impeaching behavior does not affect her believability one way or the other, and that the CSAAS evidence does not show she had been molested.’ ” (Page, supra, 114 Cal.App.5th at p. 1030, quoting Gonzales, supra, 16 Cal.App.5th 494, 504 and citing opinions agreeing with it.)

Like the panel of this court that decided Page, we agree with the analysis just quoted, and we reject Ramos’s contention that Gonzales, 18 Ramos acknowledges that arguments “similar” to his have been rejected in cases decided by a number of courts of appeal; however, he contends “those cases were wrongly decided.”

41 Lapenias, Munch, Ortiz, and People v. Ramirez, supra, 98 Cal.App.5th at pp. 219–220 were wrongly decided. (Page, supra, 114 Cal.App.5th at p. 1030.) V. DISPOSITION The judgment is affirmed.

KELETY, J.

WE CONCUR:

DATO, Acting P. J.

RUBIN, J.