People v. Perez CA1/5

Opinion

Filed 9/24/26 P. v. Perez CA1/5 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or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 This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

FIRST APPELLATE DISTRICT

DIVISION FIVE

THE PEOPLE, Plaintiff and Respondent, A171114 v. DARIO MUNDO PEREZ, (Napa County Defendant and Appellant. Super. Ct. No. 18CR002028)

In August 2020, after being found not guilty by reason of insanity in firing a gun on a police officer in a public park, defendant Dario Mundo Perez was admitted to the State Department of State Hospitals (DSH). In August 2023, Perez was restored to sanity and found eligible for community outpatient treatment. In May 2024, Perez’s outpatient status was revoked and he was returned to DSH. Perez appeals from the order revoking his outpatient status, asserting the revocation was not based on substantial evidence. We affirm. BACKGROUND I. Underlying Offense and Initial DSH Commitment On June 21, 2018, Perez made several 911 calls, reporting that he found an AR-15 assault rifle in the grass at a public park in downtown Napa. Perez told the responding police officers that he wanted to die. He then pulled out a handgun, aimed it at the officers, and fired; the gun misfired.

1 Perez was subdued, arrested, and taken into custody. It was later revealed that at the time of the offenses, Perez had been experiencing auditory hallucinations with persecutory themes, paranoia, and suicidal ideation. In August 2020, after finding Perez not guilty by reason of insanity (Pen. Code, § 1026)1 on two counts of attempted murder (§§ 187, subd. (a), 664) and related personal use of a firearm enhancements (§ 12022.53, subd. (b)), the trial court committed Perez to DSH with the maximum term of confinement of life. II. Restoration of Sanity and Outpatient Status Following a hearing in August 2023, the trial court ruled Perez had been restored to sanity, pursuant to section 1026.2, and directed that he be committed to an outpatient conditional release program (CONREP). In October 2023, Perez was placed at Gateways Satellite (Gateways), a statewide transitional residential program located in Los Angeles County; Gateways is an unlocked facility that provides the highest level of care to individuals within the CONREP system. Approximately five months later, in March 2024, Perez’s treatment team determined he was eligible for transfer to a lower-level care program—Forensic Assertive Community Treatment (FACT)—in Sacramento. However, due to an organizational change in the FACT program, Perez’s transfer was postponed. Ultimately, the transfer was canceled “due to the mounting concerns about his readiness for a lower level of care and his inability to meet the demands at Gateways . . . .” III. Proceedings to Revoke Outpatient Status In May 2024, the People filed a petition for an order revoking outpatient status under sections 1608 and 1609, based on the recommendation of CONREP Community Program Director Dolores 1 All further statutory references are to the Penal Code.

2 Flores-Chavez, LCSW. The CONREP report attached a revocation letter from Gateways which detailed the circumstances leading to the request for revocation of outpatient status. At the revocation hearing, the prosecution presented four witnesses; Perez testified on his own behalf. A. Diane Levy Diane Levy is a licensed clinical social worker and a senior forensic clinician at Gateways. At the time of her testimony, she had been working as a clinician at Gateways for 23 years. Levy had been Perez’s treating clinician/therapist during his time at Gateways. She met with him on a weekly basis. She tried to work with Perez regarding “the difference between internal feelings and emotions and external circumstances . . . .” Levy explained that Perez began developing “therapy interfering behaviors,” in which he focused on external circumstances instead of examining his internal feelings about those circumstances. Levy further explained Perez’s emotions were not the problem; rather, it was the way he went about dealing with them. Instead of addressing his emotions in various situations, he filed formal grievances with the licensing board. Although Perez was entitled to file such grievances, Levy explained this behavior was problematic because Perez was focused on external factors and blaming the program or people in the program rather than assessing his internal feelings about the circumstances. Levy testified to another example: When Perez was upset with Levy for failing to follow up on his request for new clothes, he reported the incident to her supervisor instead of first attempting to resolve the issue with her. Levy told Perez that he could talk to her about any issues he had, which he was initially receptive to, but later Perez told staff that he believed Levy was 3 “setting him up . . . .” In another instance, Perez filed a grievance when he felt he was unfairly treated at a barbecue because he was the only person who did not receive any food. Other treatment-interfering behaviors included Perez’s penchant for “splitting staff,” which is “basically going from one staff [member] to another to . . . get an answer that you like.” As an example, Perez would speak with his former clinician Brian Roy whenever he disagreed with his Gateways treatment team. Levy explained that reaching out to Roy was not problematic in itself; rather, it was Perez’s attempts to get a different answer than the one being given by his current treatment team. Levy described additional instances of treatment-interfering behavior. One involved Perez’s asking for a book on how to set up a business. She denied his request, advising him that he needed to focus on his current treatment, not on what he might do in the future. Levy encouraged self- improvement in the form of learning “coping strategies and problem solving strategies” for transitioning into the community, “rather than jumping to starting [his] own business.” Levy testified that Perez’s privilege of unsupervised group outings was suspended because staff found coffee, which was contraband, in the bathroom that Perez and three other patients shared. Levy described Perez’s words and actions as being inconsistent, which made it difficult for the team to accurately treat Perez. Throughout his seven months at Gateways, Perez would seem to be progressing when they spoke in their individual sessions, but later his actions “would reveal that he really wasn’t authentically progressing.” Levy explained that in March 2024, Perez’s CONREP representatives and Gateways staff planned to send Perez to a new program called FACT, which would have been a step down from Gateways. However, due to a 4 change at the other program, Perez’s transfer was delayed. This caused Perez’s frustration to increase, which interfered with his treatment. In the weeks following the initial recommendation and delay, Perez’s behavior demonstrated that he “needed more time and [a] more structured setting” to work on coping and problem-solving skills “without having to worry about the community because it’s a locked facility . . . .” Ultimately, Perez was moved to Golden Legacy, which is an Institution for Mental Disease (IMD) and a locked facility, for a higher level of care. B. Cynthia Lermond Cynthia Lermond, Psy.D., testified as an expert in CONREP revocations. Part of her role as the community program director for Gateways CONREP in Los Angeles County and San Diego County was to evaluate whether patients were appropriate for outpatient treatment, and she estimated that she had “interfaced with more revocations than anyone else” in California because she ran the largest CONREP program in the state. Dr. Lermond oversaw Perez’s treatment at Gateways. Concerns about his behavior quickly emerged. The treatment team saw Perez’s acting with “a pattern . . . of deceptiveness, lack of engagement in treatment, [and] disregard for treatment”; he was described as “engaging in behaviors that were suspect.” Dr. Lermond spoke with Levy about the need to firmly and directly address the behaviors with Perez and to explain to him “the importance of his meaningfully engaging in treatment and being transparent” to prepare him for a CONREP program where he would be less monitored. Dr. Lermond opined that Perez “present[ed] with a superficial engagement. [There was] a cagey and deceptive approach to treatment. There was a sense of entitlement, a bit of grandiosity, pathological issues 5 that we had a lot of questions about.” She described Perez as “seeing the treatment team as an adversary.” As Dr. Lermond and the treatment team became more familiar with Perez, they believed he may have an antisocial personality disorder. This was a risk factor because individuals with this character structure are more closely linked to violence. Additionally, “individuals who are more deceptive tend to not do well in out-patient settings where they’re counted on to be forthcoming and transparent with their treatment team who’s not with them 24/7 and needs to rely on them to report accurately and credibly on their behavior and activities in the community.” According to Dr. Lermond, Perez acted as though he “knew better” than the treatment team and was not receptive to their feedback. Dr. Lermond met with Perez due to “mounting concerns about [his] approach to treatment and his lack of engagement, his lack of transparency, [and] his deceptiveness.” The treatment team became aware that Perez had filed a multitude of grievances with the licensing board. Dr. Lermond asked Perez about the grievances and why he did not share his concerns with the team. During the meeting, the treatment team talked through specific instances he had complained of in the grievances. In one instance, Perez asked Levy for clothing, but she forgot. When asked why he simply did not remind Levy, Perez said he “ ‘shouldn’t have to [remind her], like she should just know.’ ” In another instance, a busy staff member was handing out food and did not give any to Perez, while he stood there and did not say anything. The team tried to reframe Perez’s thinking so that instead of seeing it as the staff’s acting with malicious intent or violating his rights, he could have advocated for himself and been collaborative with the team.

6 Perez’s behavior improved after the first meeting, but a few weeks later the treatment team had another meeting with Perez. After Perez requested the book about starting a business and was staff splitting, Dr. Lermond decided to meet with Perez to explain the team’s thinking in denying his request and to show him that the team was aligned. During the meeting, Dr. Lermond emphasized that Perez needed to focus on his treatment by thinking about the thought distortions he experienced and how they interfered with his relationship with the staff, and not on thinking about how to start a business someday. Perez was “pretty adversarial” throughout the discussion but eventually appeared to be on “the same page” as the treatment team; Dr. Lermond, however, did not believe he had “internalized” the team’s concerns. Dr. Lermond and the treatment team met with Perez once more before they transferred him to Golden Legacy, the higher-level treatment center. Dr. Lermond explained that Perez would benefit from the new program because there he could focus on addressing his thought distortions without the distractions of the unlocked setting. Perez seemed to understand that the team wanted to see him succeed and appreciated the team’s consideration of his case. Dr. Lermond testified that Perez had “every right to file a grievance” but that the way he went about it signaled a “lack of trust” in his care team. She insisted she “would never move someone to another level of care for a grievance.” Dr. Lermond further described Perez’s “mounting frustration with the treatment team,” which he saw as victimizing him. This was particularly concerning given Perez’s history of violence and paranoia. She said, “This is a man who sees us violating his rights and he’s a man who takes matters into his own hands with violence in the past, so that was a 7 consideration.” Given Gateways’s lower level of security and being unlocked, it was important that patients were “stable and working with [staff] and collaborative,” so that staff could manage the risk the patients posed. With that, Dr. Lermond opined that Perez’s “lack of amenability in treatment and supervision render[ed] him not suitable” for outpatient treatment. When asked on cross-examination for specific examples of Perez’s deceptiveness, Dr. Lermond stated that in one instance the staff had found a paper with Perez’s handwriting providing contact information so that his peers could file complaints. When Perez was asked about it, he was “cagey” and was “not . . . transparent about the details of what had happened.” In another example, caught on camera, Perez was observed “passing items” to a peer; when asked about it, he would not “give a straight answer.” Dr. Lermond explained she could not think of more examples because she was involved in Perez’s case on a macro level; she was more concerned with the totality of the incidents and the appropriate course of action. Dr. Lermond was aware that Perez filed five grievances. The grievances, as well as his distorted view of his interactions with the staff, suggested that Perez was experiencing low-grade paranoia. Dr. Lermond testified that she had made a “cautious referral” to the less intense program. Dr. Lermond explained that “even before [the treatment team] knew about the grievances,” she “was thinking about a higher level of care and not bringing [Perez] down. It was mounting for a while.” She further explained that the eventual decision to move Perez to a higher level of care was based on the “patterns” in his behavior, which “were not going to bode well for him going forward and it was an opportunity to give him the chance to address these things. This wasn’t punitive or reactionary” in response to the grievances.

8 C. Brian Roy Brian Roy, a mental health counselor in the forensic unit of Napa County CONREP, was Perez’s clinician at Napa State Hospital; Roy also participated in Perez’s outpatient treatment, acting as a liaison between the county and Perez’s treatment team at Gateways. Roy communicated with Perez throughout Perez’s time at Gateways; Roy would “try to reduce barriers to treatment that [Perez] was expressing with dissatisfaction with his primary clinician,” and to try to avoid staff splitting. During a treatment team meeting, Roy addressed concerns that Perez was staff splitting and needed to take the program more seriously. According to Roy, “there had been ongoing issues with [Perez’s] wanting to shape treatment; and if [Perez] felt like he was not getting the treatment that he wanted, he would go around sometimes to [Roy] to kind of circumvent treatment.” Since Perez seemed anxious to move to the lower-level program, his treatment team set the expectation with him that he meaningfully engage in treatment while he was still at Gateways. Although Perez seemed receptive in his conversations, Roy described Perez’s responses as superficial because he would respond well in the moment but then continually engage in therapy-interfering behaviors. Roy thought Perez’s outpatient status should be revoked because he had “really struggled to engage in a meaningful way that would allow for a graduation in treatment. And frankly, Gateways has communicated very clearly that they do not feel that they could continue to contain his behaviors in their program.” Because Perez could not be moved to a lower level and was not being effectively contained and treated at Gateways, Roy stated Perez should be placed in a higher-level facility, which would require revoking his outpatient status. Perez had “really struggled with this 9 orientation to the world,” such that he would externalize any feelings of discomfort. Although Perez appeared to see the value in treatment, he seemed to regard it as just another step toward ultimately being released. From the time he began at Gateways, Perez looked at things like attending group therapy as a matter of checking boxes; he seemed to focus on moving to the next step even before he started treatment. Roy described it as “very transactional in that sense and that really interfered with his ability to kind of sit and tolerate the actual treatment that was being provided to him.” Roy was concerned about Perez’s being sent to a lower level of treatment due to his history of substance abuse and recent behavior. Roy explained that although Perez’s behavior at Gateways was not overtly dangerous or violent, it communicated to the staff, “ ‘You guys are kind of failing me and I need to put you on notice [in] as dramatic [a way as] I can in this setting.’ ” Perez had “a history in less controlled settings of becoming very disregulated with drugs or alcohol in that same dynamic of ‘I feel like I’ve been let down by the community and I need to display the full effect of that failure in [a] very dramatic often dangerous fashion.’ ” Roy was concerned that if Perez’s level of care were decreased, his risk of relapse would increase. He explained that Perez’s externalizing his problems, for example, by saying he was not being kept busy enough or being provided the right things, “he becomes very helpless to stop a relapse. And then kind of helpless again to curtail his behavior once he’s relapsed because he’s been let down.” According to Roy, Perez had “lost sight of the impact” his behavior had on himself and others, and Perez did not “show a behavioral ability to kind of check that impulse, even though he’s getting a lot of guidance from the program.”

10 D. Dolores Flores-Chavez Dolores Flores-Chavez, the community program director for Napa County CONREP, had worked with Perez for approximately two years. She opined that Perez’s outpatient status should be revoked and he should return to DSH. Her first concern was that Perez had multiple changes to his diagnoses and it was still unclear what the proper diagnoses were, such as schizoaffective disorder, mood disorder, or a personality disorder. At one point Perez had been reported as having a schizoaffective disorder, but when he left Napa State Hospital his diagnoses were substance-induced disorder and multiple substance use disorder. Flores-Chavez had some concerns that Perez had a personality disorder. She explained that if Perez had a personality disorder, “the best treatment . . . would be therapy intensive treatment in order for that person to change their way of thinking, see the world in a different perspective.” This type of treatment would not be available in CONREP but would be in DSH. She added that Perez’s therapy-interfering behavior would require a “very intensive therapy,” which could not be done at an outpatient facility because the psychiatrists in those facilities could not do as “drastic changes or evaluations about their diagnoses as [DSH].” Flores-Chavez was concerned about Perez’s being in an outpatient facility due to there being less supervision. The treatment team’s focus was on managing Perez’s emotions and impulses, but if he were to access substances, his behavior could escalate to more dangerous behaviors. In the community environment, Perez would be exposed to more risk factors such as access to a grocery store or liquor store. Due to his inability to engage in treatment and practice healthy coping skills, Flores-Chavez was concerned 11 Perez would engage in unhealthy coping skills in the community because “that’s what he’s comfortable with.” E. Perez Perez testified that his current diagnosis was “drug-induced substance psychotic disorder” and that he was previously diagnosed with schizoaffective disorder and antisocial personality disorder. Gateways was in a regular neighborhood setting, where he had a lot of down time. He had been working with Levy on internal issues, which he admitted was difficult for him. He described how he lost several relatives, including his mother, while he was in Napa State Hospital and coped with his loss by working and staying busy. Instead of showing emotions, he believed “normal people in society” stayed busy as a way to cope. At Napa State Hospital, Perez was “celebrated” for working and staying busy, as well as for advocating for others, instead of being emotional. When he went to Gateways, Perez was encouraged to express his emotions; however, he explained he did not feel sad or emotional and did not want to fabricate his feelings. He was willing to work on things and wanted to “get back [to] normal” as soon as possible. Perez enjoyed reading and access to a library at Napa State Hospital; at Gateways, however, he could not have access to the books he wanted. He went to several group activities at Gateways because he liked to stay busy. Perez explained that while he had his psychosis, he believed that he was being “persecuted” by people. He believed he had telepathy and people could hear his thoughts. He previously thought that he was “a victim of a gang stalking” and that he was “implanted” with a chip. Perez described Golden Legacy, the locked IMD facility he was sent to after Gateways, as a 12 “good facility.” At that facility, there was mandatory programming that kept him busy all day. He also liked his peers and the staff at Golden Legacy. IV. Trial Court Ruling At the conclusion of the testimony and arguments from counsel, the trial court revoked Perez’s outpatient status pursuant to section 1608.2 The trial court understood that Perez wanted to “get out into the community and start living a normal life,” and commended him for the efforts he had made so far. However, the court stated that the four mental health professionals, who were “very experienced in the area of forensic mental health,” unanimously opined that Perez needed extended inpatient treatment “primarily because [Perez was] engaging in treatment superficially.” Rather, Perez was directing his efforts toward other people and external issues, “[a]nd his focus on the external issues has been distracting him from dealing with the internal issues, which again, he acknowledges he needs to work on.” The court stated that if Perez did not learn to cope with his internal issues, he would become a danger to the community if he were released. The court also addressed the issue regarding Perez’s filing several grievances with the licensing board. The court acknowledged that it had some concerns about the timing of the recommendations and the filing of the grievances. The court stated that after the treatment team learned of the grievances “it is one conclusion that they then reversed their decision to let him go to FACT because they were annoyed at his complaints. And I don’t believe that was the motivation based on all of the testimony.” Rather, the fact that the treatment team “learned of those complaints also added to their 2 The court determined the prosecution had not met its burden of establishing revocation under section 1609 as it had not established by a preponderance of the evidence that Perez was a danger to the health and safety of others.

13 preexisting concerns that he was . . . superficially engaging in treatment and not being honest with his treatment team and trying to work with them is another example of him externalizing issues rather than engaging in the treatment.” Therefore, the court found Perez required extended inpatient treatment and granted the section 1608 petition revoking Perez’s outpatient status. DISCUSSION I. State Hospital Commitment and Conditional Release to Outpatient Status Section 1026 provides that if the trier of fact “finds the defendant was insane at the time of the offense, the trial court shall commit the defendant to a state hospital or other appropriate public or private facility for the care and treatment of the mentally disordered, or place the defendant on outpatient status pursuant to section 1600 et seq. (§ 1026, subd. (a); [citations].)” (People v. Dobson (2008) 161 Cal.App.4th 1422, 1431.) “Subsequent release from a state hospital after an insanity commitment occurs upon (1) restoration of sanity pursuant to section 1026.2, (2) expiration of the maximum term of commitment under section 1026.5, or (3) approval of outpatient status under section 1600 et seq.” (People v. Cross (2005) 127 Cal.App.4th 63, 72 (Cross).) “[A] defendant may be placed on outpatient status upon the recommendation of the state hospital director and the community program director with the court’s approval after a hearing. (§ 1603; [citation].)” (Cross, supra, 127 Cal.App.4th at p. 72.) “However, ‘ “[o]utpatient status is not a privilege given the [offender] to finish out his [or her] sentence in a less restricted setting; rather it is a discretionary form of treatment to be ordered by the committing court only if the medical experts who plan and provide treatment conclude that such treatment would benefit the [offender] and 14 cause no undue hazard to the community.” ’ ” (Ibid., 3d bracketed insertion added.) Once a person has been placed on outpatient status, that status may be revoked under either section 1608 or section 1609. Section 1609 governs revocation proceedings initiated by the prosecution based on concerns that an individual “is a danger to the health and safety of others while on [outpatient] status,” whereas section 1608 “requires a finding that the patient needs extended inpatient treatment or refuses to accept further outpatient treatment. It does not require the court to find that the patient is a danger to the health and safety to others.” (People v. DeGuzman (1995) 33 Cal.App.4th 414, 420 (DeGuzman).) II. Sufficiency of the Evidence In reviewing an order revoking outpatient status under section 1608, we uphold the trial court’s factual findings if supported by substantial evidence. (DeGuzman, supra, 33 Cal.App.4th at p. 420.) The prosecution bears the burden of proof at a revocation of outpatient status hearing to demonstrate by a preponderance of the evidence that the patient requires extended inpatient treatment or refuses to accept further outpatient treatment and supervision. (Id. at pp. 419–420.) We review the trial court’s order regarding outpatient status for an abuse of discretion. (People v. Bartsch (2008) 167 Cal.App.4th 896, 900.) “Under that standard, it is not sufficient to show facts affording an opportunity for a difference of opinion. [Citation.] ‘[D]iscretion is abused only if the court exceeds the bounds of reason, all of the circumstances being considered.’ ” (Cross, supra, 127 Cal.App.4th at p. 73.) Substantial evidence supports the trial court’s decision to revoke Perez’s outpatient status. Four witnesses, whom the trial court found 15 credible, unanimously agreed that Perez’s “treatment interfering behaviors” hindered his progress in an outpatient setting. Although it is true, as Perez notes, he was “never verbally or physically aggressive with staff,” this is not relevant to a section 1608 revocation, which is concerned with whether the patient needs extended inpatient treatment or refuses to accept further outpatient treatment. (Cf. § 1609 [“prosecutor is of the opinion that the person is a danger to the health and safety of others while on [outpatient] status”].) Perez contends “the sole evidence” on which the treatment team based its opinions was due to the grievances he made about the facility. The record belies this claim. The combined testimony of Perez’s treatment team revealed: (1) he engaged in “splitting the staff,” by seeking to get more favorable responses from different staff members; (2) he viewed his treatment team as an “adversary”; (3) he ascribed malicious intent to actions of staff members; (4) he paid lip service to therapy, basically telling the team what he thought it wanted to hear while failing to address his underlying emotions; (5) he believed he “knew better” than the treatment team and was not receptive to its feedback; (6) when confronted with a note containing his handwriting, he all but denied he wrote it; (7) he would not “give a straight answer” about an incident captured on camera, in which he was seen giving something to another patient; and (8) he externalized any feelings of discomfort. Moreover, the record reflects that the filing of the grievances was not the issue. Rather, it was Perez’s failure to address his feelings about the situations leading to the grievances—for example, not getting the things he requested (clothing, book) or feeling disrespected (being the only one not to 16 get food at the barbecue). Instead of working on the underlying emotions, Perez elected to externally direct his focus by filing the grievances. As for the timing of the grievances vis-à-vis the revocation petition, Dr. Lermond explained that even before she knew about Perez’s complaints, she had reservations about transferring him to a lower level of care. She described her decision to transfer him as a “cautious referral” based on “mounting” concerns about Perez’s behaviors. Dr. Lermond testified that she would never transfer a person’s level of care based on a grievance. She further insisted the decision to transfer Perez to a higher level of care was not a “punitive or reactionary” response to the grievances. The trial court found this testimony to be credible. We will not second-guess this determination. (People v. Brown (2014) 59 Cal.4th 86, 105–106 [“ ‘In reviewing a challenge to the sufficiency of the evidence, . . . [w]e do not reweigh the evidence or reevaluate a witness’s credibility’ ”].) Finally, irrespective of Perez’s diagnosis,3 the record makes clear that his current pattern of behavior—described as cagey, manipulative, distrustful, adversarial, and superficially engaged—was not compatible with the transparency and meaningful engagement required at Gateways. Accordingly, we conclude substantial evidence supports the revocation of Perez’s outpatient status under section 1608.

3 Although Perez asserts the concerns about him having a personality disorder were speculative, the record amply supports the revocation based on the evidence discussed herein; accordingly, we do not separately address this argument.

17 DISPOSITION The order revoking Perez’s outpatient status under section 1608 is affirmed.

Jackson, P. J.

WE CONCUR:

Burns, J. Chou, J.

A171114/People v. Dario Mundo Perez