State assisted-living licensing record · Wisconsin DQA · record as pulled October 1, 2026· Not the federal nursing home survey
Country Terrace Black River Falls II
642 E 3rd St, Black River Falls, WI 54615 · Jackson County · 25 licensed beds
DQA licence number 0016076 · licensed, regular licence · first licensed March 2016
The licence
Licensed by DQA · Community-based residential facility · For profit · managed by Country Terrace of Wisconsin INC
Licence details, as listed by DQA
- Licensed as
- Community-based residential facility
- Class
- Class CNA (non-ambulatory)
- Regular licence issued
- March 17, 2016
- Client groups served
- Advanced aged, Irreversible dementia/Alzheimer's, Physically disabled, Terminally ill
- Ownership
- Limited Liability Company
Position within Wisconsin
35 citations — more than 98% 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 Country Terrace Black River Falls II
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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.
How that compares
Compared with the median licensed assisted living facility in Wisconsin. Within-state only.
| Measure | Citations |
|---|---|
| This facility | 35 |
| Median facility in Wisconsin | 1 |
Visit history
| Visit | Type | Citations |
|---|---|---|
| October 31, 2023 | complaint investigation, verification visit | 0 |
| March 27, 2024 | complaint investigation | 14 |
| July 11, 2024 | complaint investigation | 0 |
| October 10, 2024 | complaint investigation, verification visit | 4 |
| March 3, 2025 | survey, complaint investigation, verification visit | 12 |
| December 1, 2025 | complaint investigation, verification visit | 4 |
| March 3, 2026 | complaint investigation | 1 |
| May 13, 2026 | complaint investigation, verification visit | 0 |
What the citations cover
- Resident care 13
- Records and administration 7
- Medication 6
- Staffing and training 3
- Other 6
| Category | Citations |
|---|---|
| Resident care | 13 |
| Records and administration | 7 |
| Medication | 6 |
| Staffing and training | 3 |
| Physical plant | 3 |
| Life safety | 2 |
| Food service | 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.
May 13, 2026 — complaint investigation, verification visit, nothing cited
March 3, 2026 — complaint investigation, 1 citation
| Tag | What DQA checks |
|---|---|
| N432 | Medication administration |
December 1, 2025 — complaint investigation, verification visit, 4 citations
March 3, 2025 — survey, complaint investigation, verification visit, 12 citations
| Tag | What DQA checks |
|---|---|
| N214 | Administrator shall supervise daily operation |
| N277 | Continuing education |
| N310 | Admission agreement include services, charges |
| N343 | Explanation of rights, grievance procedure |
| N381 | Pre-admission and ongoing assessments |
| N386 | Comprehensive Individualized Service Plan |
| N392 | Resident satisfaction evaluation |
| N393 | Initial evaluation of evacuation limitations |
| N415 | Documentation of medication administration |
| N427 | Leisure time activities |
| N481 | Environment safe, clean, and comfortable |
| N525 | Fire drills |
October 10, 2024 — complaint investigation, verification visit, 4 citations
July 11, 2024 — complaint investigation, nothing cited
March 27, 2024 — complaint investigation, 14 citations
| Tag | What DQA checks |
|---|---|
| N158 | Caregiver: Investigating abuse & neglect |
| N165 | Reporting incidents with serious injury |
| N214 | Administrator shall supervise daily operation |
| N229 | Employee records available upon request |
| N239 | Department-approved training courses |
| N352 | Rights of Residents: Receive medication |
| N410 | Medication error or adverse reaction |
| N415 | Documentation of medication administration |
| N425 | Personal care |
| N431 | Health monitoring |
| N441 | Hand washing |
| N452 | Food safety |
| N480 | Access to resident records |
| N481 | Environment safe, clean, and comfortable |
October 31, 2023 — complaint investigation, verification visit, nothing cited
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.