State assisted-living licensing record · Wisconsin DQA · record as pulled October 1, 2026· Not the federal nursing home survey
Cloverleaf Terrace LLC
401 Center St, Birnamwood, WI 54414 · Shawano County · 15 licensed beds
DQA licence number 0015404 · licensed, regular licence · first licensed December 2014
The licence
Licensed by DQA · Community-based residential facility · For profit · managed by Cloverleaf Terrace LLC
Licence details, as listed by DQA
- Licensed as
- Community-based residential facility
- Class
- Class CNA (non-ambulatory)
- Probationary licence issued
- December 23, 2014
- Regular licence issued
- January 1, 2016
- Client groups served
- Advanced aged, Irreversible dementia/Alzheimer's, Physically disabled, Terminally ill, Developmentally disabled, Traumatic brain injury
- Ownership
- Limited Liability Company
Position within Wisconsin
17 citations — more than 93% of the 1,894 licensed assisted living facilities in Wisconsin. Compared only within Wisconsin: a citation from DQA means what it means in Wisconsin, and there is no national assisted living record to compare to. Counted over 3 years, which holds two or three routine inspections. How this is calculated
Not in this record
Fire and building code inspection, severity, the surveyor's narrative, and enforcement. The fire and building code inspection of a Wisconsin facility is the local fire department's and the state building authority's, and is not part of DQA's record; what DQA itself cites about the building — its physical environment, building maintenance, building support systems and fire safety rules — is here. DQA assigns no severity on these statements, and the plan of correction is the facility's own text and is not republished. Forfeitures and orders are issued in separate enforcement letters and are not republished, and an owner that is a sole proprietor is not named. Adult family homes, three or four beds, are also assisted living in Wisconsin and are not included.
Get an email about Cloverleaf Terrace LLC
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Building-related citations
The citations about the building itself — physical plant and emergency management. Usually the maintenance side’s to fix.
- N394 Annual evaluation of evacuation limitsApril 23, 2026
- N525 Fire drillsApril 23, 2026
- N526 Other evacuation drillsApril 23, 2026
- N538 Fire detection systems inspected annuallyApril 23, 2026
- N481 Environment safe, clean, and comfortableJuly 19, 2024
- N525 Fire drillsJuly 19, 2024
- N526 Other evacuation drillsJuly 19, 2024
How that compares
Compared with the median licensed assisted living facility in Wisconsin. Within-state only.
| Measure | Citations |
|---|---|
| This facility | 17 |
| Median facility in Wisconsin | 1 |
Visit history
| Visit | Type | Citations |
|---|---|---|
| July 19, 2024 | complaint investigation | 7 |
| January 15, 2025 | verification visit | 0 |
| April 23, 2026 | survey, complaint investigation | 10 |
What the citations cover
- Life safety 6
- Resident care 4
- Staffing and training 3
- Records and administration 2
- Other 2
| Category | Citations |
|---|---|
| Life safety | 6 |
| Resident care | 4 |
| Staffing and training | 3 |
| Records and administration | 2 |
| Medication | 1 |
| Physical plant | 1 |
Every visit on file since October 2023
As published by DQA, newest first, including visits that cited nothing. The wording is DQA’s own.
April 23, 2026 — survey, complaint investigation, 10 citations
| Tag | What DQA checks |
|---|---|
| N214 | Administrator shall supervise daily operation |
| N219 | Licensee conduct caregiver background check |
| N220 | Employees screened for communicable disease |
| N277 | Continuing education |
| N394 | Annual evaluation of evacuation limits |
| N416 | Other administration given or delegated by RN |
| N426 | Supervision |
| N525 | Fire drills |
| N526 | Other evacuation drills |
| N538 | Fire detection systems inspected annually |
January 15, 2025 — verification visit, nothing cited
July 19, 2024 — complaint investigation, 7 citations
Reflects the DQA record as pulled October 1, 2026. A recent visit may not appear yet. This is the Wisconsin state licensing record; it is not the federal nursing home survey and the two are never combined.