State assisted-living licensing record · Wisconsin DQA · record as pulled October 1, 2026· Not the federal nursing home survey
Kelly House
121 S 5th St, Evansville, WI 53536 · Rock County · 8 licensed beds
DQA licence number 110260 · licensed, regular licence · first licensed August 1989
The licence
Licensed by DQA · Community-based residential facility · For profit · managed by Saee INC.
Licence details, as listed by DQA
- Licensed as
- Community-based residential facility
- Class
- Class CNA (non-ambulatory)
- Probationary licence issued
- August 2, 1989
- Regular licence issued
- August 2, 1990
- Client groups served
- Advanced aged, Irreversible dementia/Alzheimer's, Developmentally disabled, Emotionally disturbed/mental illness
- Ownership
- Corporation - Business
Position within Wisconsin
6 citations — more than 77% 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 Kelly House
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Building-related citations
The citation about the building itself — physical plant and emergency management. Usually the maintenance side’s to fix.
- N499 Toxic substancesSeptember 18, 2025
How that compares
Compared with the median licensed assisted living facility in Wisconsin. Within-state only.
| Measure | Citations |
|---|---|
| This facility | 6 |
| Median facility in Wisconsin | 1 |
Visit history
| Visit | Type | Citations |
|---|---|---|
| September 18, 2025 | verification visit | 6 |
| November 24, 2025 | verification visit | 0 |
What the citations cover
- Medication 2
- Resident care 2
- Physical plant 1
- Records and administration 1
| Category | Citations |
|---|---|
| Medication | 2 |
| Resident care | 2 |
| Physical plant | 1 |
| Records and administration | 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.
November 24, 2025 — verification visit, nothing cited
September 18, 2025 — verification visit, 6 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.