State assisted-living licensing record · Wisconsin DQA · record as pulled October 1, 2026· Not the federal nursing home survey
Evergreen Home Care LLC
1003 Tamarack Way, Verona, WI 53593 · Dane County · 8 licensed beds
DQA licence number 0014896 · licensed, regular licence · first licensed January 2014
The licence
Licensed by DQA · Community-based residential facility · For profit
Licence details, as listed by DQA
- Licensed as
- Community-based residential facility
- Class
- Class CNA (non-ambulatory)
- Probationary licence issued
- January 9, 2014
- Regular licence issued
- January 1, 2015
- Client groups served
- Advanced aged, Irreversible dementia/Alzheimer's, Physically disabled, Emotionally disturbed/mental illness
- Ownership
- Limited Liability Company
Position within Wisconsin
13 citations — more than 90% 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.
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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 | 13 |
| Median facility in Wisconsin | 1 |
Visit history
| Visit | Type | Citations |
|---|---|---|
| October 10, 2023 | survey, complaint investigation | 9 |
| April 17, 2024 | complaint investigation, verification visit | 0 |
| January 7, 2025 | complaint investigation | 4 |
| July 9, 2025 | survey, verification visit | 0 |
What the citations cover
- Resident care 5
- Physical plant 4
- Records and administration 3
- Life safety 1
| Category | Citations |
|---|---|
| Resident care | 5 |
| Physical plant | 4 |
| Records and administration | 3 |
| Life safety | 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.
July 9, 2025 — survey, verification visit, nothing cited
January 7, 2025 — complaint investigation, 4 citations
April 17, 2024 — complaint investigation, verification visit, nothing cited
October 10, 2023 — survey, complaint investigation, 9 citations
| Tag | What DQA checks |
|---|---|
| N164 | Reporting when law enforcement is called |
| N328 | Involuntary discharge notice requirements |
| N389 | Service plans updated annually or on changes |
| N394 | Annual evaluation of evacuation limits |
| N433 | Behavior management |
| N454 | Resident record maintained |
| N481 | Environment safe, clean, and comfortable |
| N485 | Clean sheets, pillowcases, and towels |
| N668 | Total/openable window area |
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.