The living room smelled of urine and disinfectant. A cupboard by the door contained a can of odor eliminator, D-con and Pepto-Bismol. The dirty carpet was strewn with empty syringe packaging, bits of paper, shoes, kids' bicycles, a box of Huggies, two folded lawn chairs and a cell phone broken into pieces. On the wall behind the television hung a series of educational flash cards showing household items.

A boy, who looked 6 or 7 and wearing only a diaper, peered through the railings of the stairs leading to the second floor.

"He's autistic, but you can say hi," his mother said.

"Hi, buddy," Ellis said, then told the mother the allegations.

"Can you come in here, Rob?" Alex called to a man putting dishes away in the kitchen. He was shirtless. Apologetic about the messy house.

The report was wrong, he said. "We have all our utilities." A former paratransit driver, he recently lost his job. "But I'm going to find another one soon."

Alex confided in Ellis about her medical problems. "Mild CP," a seizure disorder and diabetes. She patted her belly.

"How far along are you?" Ellis asked.

"Four months."

With her health issues and the $600-a-month rent, they were struggling, she said, but she did not understand why someone would say she was unable to care for her children.

Upstairs, the other social worker asked Rob to turn on the water in a trash-filled sink and flush the toilet, then peeked into a cluttered room with bunk beds.

"We just had it cleaned up, but we let the kids play in here," Rob said, explaining that his two sons from a previous relationship were visiting over the weekend.

He led her to the main bedroom, where a 3-year-old girl, eating a pretzel and mustard, flashed them a megawatt smile from atop the rumpled bed.

The family, he said, planned to move into a larger place, at $100 more a month.

"If you can't afford 600, how are you going to afford 700?" Ellis asked.

"Long story," Alex said.

"Do you have any relatives you can stay with?"

"No."

Gently, Ellis suggested: "After this, would you consider birth control?"

"I have trouble with birth control because of my medicines," Alex said.