Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 1 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

1ST CHOICE ADULT FAMILY (0015993) 1ST CHOICE ADULT FAMILY Type: AFH ADVANCED AGED (262) 676-9756 Class: 3341 HAMLIN DEVELOPMENTALLY DISABLED RACINE WI 53403 RHONDA GRIFFIN Gender - Capacity: M/F - 4 (262) 676-9756 RHONDA GRIFFIN 1536 TAYLOR AVE Low/High rate: 0/7,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 11/28/2016 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY A BETTER WAY ADULT FAMILY HOME LLC (0017677) A BETTER WAY ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 822-7508 Class: 5201 LILAC LN ADVANCED AGED RACINE WI 53406 TERESA PEREZ Gender - Capacity: M/F - 4 (262) 822-7508 ESTEFANIA OCAMPO 1318 NORTH ST Low/High rate: 4,750/10,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 07/23/2019 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY A GOLDEN STAR AFH (0016654) A GOLDEN STAR AFH LLC Type: AFH ADVANCED AGED (262) 412-4264 Class: 3337 CHARLES STREET CORRECTIONAL CLIENTS RACINE WI 53402 VALERIE KING Gender - Capacity: M/F - 4 (262) 456-2821 DESIREE VEASEY 3801 MONARCH DR STE 1C Low/High rate: 6,500/9,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 05/23/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY A GOLDEN STAR AFH I (0017562) A GOLDEN STAR AFH LLC Type: AFH HCBS COMPLIANT (262) 412-4274 Class: 4205 MONTEREY DR ADVANCED AGED RACINE WI 53402 DESIREE VEASEY Gender - Capacity: M/F - 4 (262) 456-2821 DESIREE VEASEY 3801 MONARCH DR STE 1C Low/High rate: 6,500/9,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 07/17/2019 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY A GOLDEN STAR AFH III (0017075) A GOLDEN STAR AFH LLC Type: AFH HCBS COMPLIANT (262) 412-4274 Class: 1638 ERIE ST ADVANCED AGED RACINE WI 53402 DESIREE VEASEY Gender - Capacity: M/F - 4 (262) 456-2821 DESIREE VEASEY 3801 MONARCH DR STE 1C Low/High rate: 6,500/9,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 03/13/2018 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL TRAUMATIC BRAIN INJURY A GOLDEN STAR AFH V (0017971) A GOLDEN STAR AFH LLC Type: AFH HCBS COMPLIANT (262) 412-4274 Class: 4201 MONTEREY DRIVE ADVANCED AGED RACINE WI 53406 DESIREE VEASEY Gender - Capacity: M/F - 4 (262) 456-2821 DESIREE VEASEY 3801 MONARCH DRIVE Low/High rate: 6,500/9,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 02/06/2020 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY *The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 2 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

A LOVING CARE GROUP HOMES II LLC (0014287) A LOVING CARE GROUP HOMES LLC Type: AFH HCBS COMPLIANT (262) 939-3666 Class: 1341 VIRGINIA ST ADVANCED AGED RACINE WI 53403 PARIT PATEL Gender - Capacity: M/F - 4 (262) 939-3666 PARIT PATEL 2054 KEARNEY AVE Low/High rate: 7,750/12,400 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 01/07/2013 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING A LOVING CARE GROUP HOMES LLC (0013619) A LOVING CARE GROUP HOMES LLC Type: AFH HCBS COMPLIANT (262) 633-4977 Class: 2710 WESTLAWN AVE ADVANCED AGED RACINE WI 53405 PARIT PATEL Gender - Capacity: M/F - 4 (262) 939-3666 PARIT PATEL 2054 KEARNEY AVE Low/High rate: 7,750/12,400 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 02/16/2011 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED

A NATURALLY NURTURING PLACE (0015742) NATURALLY NURTURED LLC Type: AFH HCBS COMPLIANT (262) 752-3830 Class: 901 OSTERGAARD AVE ADVANCED AGED RACINE WI 53406 CHANEL NELSON Gender - Capacity: M/F - 3 (262) 995-7505 CHANEL NELSON 1430 VILLA ST Low/High rate: 3,500/10,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 09/01/2015 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY A SERENE ABODE LLC (0017245) A SERENE ABODE LLC Type: AFH HCBS COMPLIANT (262) 583-0005 Class: 1606 CRABTREE LANE ADVANCED AGED RACINE WI 53406 KARISSA LACY BARKER Gender - Capacity: M/F - 4 (262) 583-0005 KARISSA LACY BARKER 1102 WALTON AVE Low/High rate: 3,000/10,500 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53402 Initial License: 07/03/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY A+ JUST LIKE FAMILY 2 LLC (0014635) A+ JUST LIKE FAMILY LLC Type: AFH HCBS COMPLIANT (262) 412-3269 Class: 2111 MOUNT PLEASANT STREET ADVANCED AGED RACINE WI 53404 MIRANDA YOUNG Gender - Capacity: M/F - 4 (262) 412-3269 MIRANDA YOUNG 620 SILENT SUNDAY Low/High rate: 2,800/10,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53402 Initial License: 06/05/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL

A+ JUST LIKE FAMILY 3 LLC (0016987) A+ JUST LIKE FAMILY LLC Type: AFH ADVANCED AGED (262) 412-3269 Class: 1108 ILLINOIS ST DEVELOPMENTALLY DISABLED RACINE WI 53405 MIRANDA YOUNG Gender - Capacity: M/F - 4 (262) 412-3269 MIRANDA YOUNG 620 SILENT SUNDAY CT Low/High rate: 3,800/8,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53402 Initial License: 01/11/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY A+ JUST LIKE FAMILY AFH (0013921) A+ JUST LIKE FAMILY LLC Type: AFH HCBS COMPLIANT (262) 412-3269 Class: 1926 DEANE BLVD ADVANCED AGED RACINE WI 53403 MIRANDA YOUNG Gender - Capacity: M/F - 4 (262) 412-3269 MIRANDA YOUNG 620 SILENT SUNDAY Low/High rate: 5,565/8,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 02/20/2012 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 3 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

A+ JUST LIKE FAMILY FRANKLIN A (0017553) A+ JUST LIKE FAMILY FRANKLIN AFH Type: AFH HCBS COMPLIANT (262) 412-3269 Class: 1619 FRANKLIN ST A ADVANCED AGED RACINE WI 53403 MIRANDA YOUNG Gender - Capacity: M/F - 4 (262) 412-3269 MIRANDA YOUNG 1347 RAMONA DR Low/High rate: 5,000/18,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 03/03/2020 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY A+ JUST LIKE FAMILY FRANKLIN B (0017554) A+ JUST LIKE FAMILY AFH Type: AFH HCBS COMPLIANT (262) 412-3269 Class: 1619 FRANKLIN ST B ADVANCED AGED RACINE WI 53403 MIRANDA YOUNG Gender - Capacity: M/F - 4 (262) 412-3269 MIRANDA YOUNG 1347 RAMONA DR Low/High rate: 5,000/18,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53403 Initial License: 03/03/2020 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY AARNA FAMILY CARE LLC (0016897) AARNA FAMILY CARE LLC Type: AFH ADVANCED AGED (262) 939-6661 Class: 2427 RUSSET ST DEVELOPMENTALLY DISABLED RACINE WI 53405 TARAL PATEL Gender - Capacity: M/F - 4 (262) 412-1482 TARAL PATEL 3839 BLOSSOM DR Low/High rate: 3,500/9,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53406 Initial License: 04/04/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED AARNA FAMILY CARE LLC (0017908) AARNA FAMILY CARE LLC Type: AFH HCBS COMPLIANT (262) 939-6661 Class: 3823 MEACHEM ROAD ADVANCED AGED MT PLEASANT WI 53403 TARAL PATEL Gender - Capacity: M/F - 4 (262) 412-1482 DIPAL PATEL 3839 BLOSSOM DRIVE Low/High rate: 3,500/9,500 DEVELOPMENTALLY DISABLED County: RACINE MT PLEASANT WI 53406 Initial License: 01/23/2020 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ABOVE & BEYOND AFH III (0017610) ABOVE AND BEYOND ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 417-2796 Class: 5214 16TH ST ADVANCED AGED RACINE WI 53406 PRISCELLA WHITE Gender - Capacity: M/F - 4 (262) 752-8350 PRISCELLA WHITE 5214 16TH ST Low/High rate: 5,000/10,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 11/11/2019 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ABOVE & BEYOND AFH PHASE I (0018431) ABOVE BEYOND ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 417-2796 Class: 119 CRAB TREE LANE ADVANCED AGED RACINE WI 53406 PRISCELLA K WHITE Gender - Capacity: M/F - 4 (262) 583-4619 PRISCELLA K WHITE 5404 WRIGHT AVENUE Low/High rate: 3,500/5,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 04/26/2021 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ABOVE AND BEYOND ADULT FAMILY HOME (0013672) ABOVE AND BEYOND ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 417-2796 Class: 5404 WRIGHT AVE ADVANCED AGED RACINE WI 53406 PRISCELLA WHITE Gender - Capacity: M/F - 4 (262) 456-2250 PRISCELLA WHITE PO Box 85471 Low/High rate: 3,600/4,000 DEVELOPMENTALLY DISABLED County: RACINE Racine WI 53406 Initial License: 04/05/2011 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 4 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

ALLYSONS ADULT HOME II (0016469) ALLYSONSADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 672-9735 Class: 3600 10TH AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53403 ALLYSON BOUIE Gender - Capacity: M/F - 3 ALLYSON BOUIE 3669 ERIE ST Low/High rate: 4,711/8,617 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 04/06/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN I (390119) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 1683 PERRY AVE DEVELOPMENTALLY DISABLED RACINE WI 53405 DAVID DUFFECK Gender - Capacity: M - 4 (262) 633-7484 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 2,850/5,000 PUBLIC FUNDING County: RACINE RACINE WI 53406 Initial License: 02/01/1989 TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN II (0008611) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 4212 DURAND AVE DEVELOPMENTALLY DISABLED RACINE WI 53406 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 554-8856 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 3,400/3,400 TRAUMATIC BRAIN INJURY County: RACINE RACINE WI 53406 Initial License: 05/01/1987 ALPHA HOMES OF WISCONSIN III (390120) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 1727 STODDARD CIRCLE DEVELOPMENTALLY DISABLED RACINE WI 53406 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 886-5139 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 3,150/3,150 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 11/01/1988 PUBLIC FUNDING ALPHA HOMES OF WISCONSIN IV (390121) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 1427 OHIO ST DEVELOPMENTALLY DISABLED RACINE WI 53405 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 633-6845 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 3,420/3,420 PUBLIC FUNDING County: RACINE RACINE WI 53406 Initial License: 11/01/1987 TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN V (0008612) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 5238 ADMIRALTY DR DEVELOPMENTALLY DISABLED RACINE WI 53406 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 554-6035 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 2,850/5,000 PUBLIC FUNDING County: RACINE RACINE WI 53406 Initial License: 12/01/1987 TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN VI (0008614) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 701 CARLTON DR DEVELOPMENTALLY DISABLED RACINE WI 53404 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 639-5449 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 4,740/4,740 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 11/01/1998 PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN VII (390123) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 5405 ERIE ST DEVELOPMENTALLY DISABLED RACINE WI 53402 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 639-4010 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 4,860/4,860 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 09/04/1990 PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN XIX (0012193) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 8917 CITADEL TERRACE DEVELOPMENTALLY DISABLED STURTEVANT WI 53177 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 886-3328 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 5,910/7,710 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 11/20/2008 PUBLIC FUNDING TRAUMATIC BRAIN INJURY

ALPHA HOMES OF WISCONSIN XV (0009193) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 2125 PARKWAY DR DEVELOPMENTALLY DISABLED CALEDONIA WI 53108 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 681-7868 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 5,010/5,010 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 06/15/2001 PUBLIC FUNDING TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 5 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

ALPHA HOMES OF WISCONSIN XVI (0010519) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 3820 29TH ST DEVELOPMENTALLY DISABLED KENOSHA WI 53144 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 551-0495 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 5,510/5,510 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 02/03/2005 PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN XVII (0010747) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 3657 MERLIN CT DEVELOPMENTALLY DISABLED STURTEVANT WI 53177 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 886-3328 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 5,700/5,700 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 05/26/2005 PUBLIC FUNDING TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN XVIII (0011654) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 2126 SUTTON DR DEVELOPMENTALLY DISABLED RACINE WI 53406 DAVID DUFFECK Gender - Capacity: M/F - 4 (262) 886-1766 DAVID DUFFECK 6216 WASHINGTON AVE SUITE D Low/High rate: 3,750/3,750 PUBLIC FUNDING County: RACINE RACINE WI 53406 Initial License: 10/30/2006 TRAUMATIC BRAIN INJURY ALPHA HOMES OF WISCONSIN XX (0012314) ALPHA HOMES OF WISCONSIN INC Type: AFH HCBS COMPLIANT (262) 886-3328 Class: 6435 KINZIE AVE DEVELOPMENTALLY DISABLED RACINE WI 53406 DAVID J DUFFECK Gender - Capacity: M/F - 4 (262) 886-3328 DAVID DUFFECK 6216 WASHINGTON AVE Low/High rate: 5,910/7,710 PHYSICALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 08/20/2008 PUBLIC FUNDING TRAUMATIC BRAIN INJURY AMYS ADULT FAMILY HOME 3 (0014725) AMYS ADULT FAMILY HOME, LLC Type: AFH HCBS COMPLIANT (262) 412-3355 Class: 1719 GRAND AVENUE ADVANCED AGED RACINE WI 53403 AMY HAMILTON Gender - Capacity: M/F - 3 (262) 637-7117 AMY HAMILTON 1701 WEST 6TH STREET Low/High rate: 5,000/10,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53404 Initial License: 11/14/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY AMYS ADULT FAMILY HOME 4 (0016036) AMYS ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 412-3355 Class: 2062 GEORGIA AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53404 AMY HAMILTON Gender - Capacity: M/F - 3 (262) 412-3355 AMY HAMILTON 1701 WEST 6TH ST Low/High rate: 5,550/12,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 12/05/2016 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ANGEL CARE LIVING FACILITIES LLC (0017832) ANGEL CARE LIVING FACILITIES LLC Type: AFH HCBS COMPLIANT (262) 721-5080 Class: 4237 LATHROP AVE ADVANCED AGED MOUNT PLEASANT WI 53403 PHILIP ALLEN Gender - Capacity: M/F - 4 (262) 721-5080 PHILIP ALLEN 4237 LATHROP AVE Low/High rate: 5,000/5,500 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 09/27/2019 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 6 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

BEACON OF HOPE ADULT FAMILY HOME (0014258) BEACON OF HOPE RESIDENTIAL CARE Type: AFH HCBS COMPLIANT (262) 989-7125 Class: 3945 JACOB CT ADVANCED AGED MOUNT PLEASANT WI 53403 RODERICK F EVANS Gender - Capacity: M/F - 4 (262) 989-7125 RODERICK F EVANS 3945 JACOB CT Low/High rate: 4,057/8,113 DEVELOPMENTALLY DISABLED County: RACINE MOUNT PLEASANT WI 53403 Initial License: 07/25/2012 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY BELLS HAVEN LLC (0017576) BELLS HAVEN LLC Type: AFH HCBS COMPLIANT (612) 386-5751 Class: 2512 DIANE AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53404 BEVERLY ROGERS Gender - Capacity: M/F - 4 (612) 386-5751 BEVERLY ROGERS 2512 DIANE AVE Low/High rate: 7,500/7,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53404 Initial License: 12/15/2020 IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY BEST CARE RESIDENTIAL 2 (0018454) GREGORY MOORE Type: AFH HCBS COMPLIANT (262) 497-4433 Class: 1601 W 6TH ST ADVANCED AGED RACINE WI 53403 GREGORY MOORE Gender - Capacity: M/F - 4 (262) 497-4433 GREGORY MOORE 2875 E PEBBLE CIRCLE Low/High rate: 3,000/10,000 DEVELOPMENTALLY DISABLED County: RACINE STURTEVANT WI 53177 Initial License: 05/26/2021 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY BEST CARE RESIDENTIAL AFH (0015141) GREGORY MOORE Type: AFH HCBS COMPLIANT (262) 497-4433 Class: 2001 CENTER STREET ADVANCED AGED RACINE WI 53403 GREGORY MOORE Gender - Capacity: M/F - 3 (262) 497-4433 GREGORY MOORE 2001 Center Street Low/High rate: 3,000/10,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 07/07/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

BEST HOME CARE OF WI (0015329) YOLANDA MORA Type: AFH HCBS COMPLIANT (262) 822-5336 Class: 1331 BLUFF AVENUE ADVANCED AGED RACINE WI 53403 YOLANDA MORA Gender - Capacity: M/F - 4 (262) 456-0035 YOLANDA MORA 1331 BLUFF AVENUE Low/High rate: 5,000/6,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 10/29/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

BEST HOME CARE OF WI 2 LLC (0016768) BEST HOME CARE OF WI 2 LLC Type: AFH ADVANCED AGED (262) 822-5336 Class: 2524 DONNA AVE DEVELOPMENTALLY DISABLED RACINE WI 53404 YOLANDA NAVA Gender - Capacity: M/F - 3 (262) 822-5336 YOLANDA NAVA 1331 BLUFF AVE Low/High rate: 5,000/6,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 01/10/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 7 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

BLESSED ASSURANCE ADULT FAMILY HOME (0013784) LEKESHA GRAYS Type: AFH HCBS COMPLIANT (262) 994-5485 Class: 5645 REGENCY HILLS DR ALCOHOL/DRUG DEPENDENT RACINE WI 53406 LEKESHA GRAYS Gender - Capacity: M/F - 4 (262) 672-3936 LEKESHA GRAYS 141 MAIN ST APT 122 Low/High rate: 2,500/9,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53403 Initial License: 09/29/2011 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY BRESHA SERENITY HOUSE (0009950) DEPHENIA CONLEY Type: AFH HCBS COMPLIANT (262) 456-2008 Class: 5638 BYRD AVE ADVANCED AGED RACINE WI 53406 DEPHENIA CONLEY Gender - Capacity: M/F - 4 (262) 456-2008 DEPHENIA CONLEY 5638 BYRD AVE Low/High rate: 4,562/5,049 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 02/06/2003 PHYSICALLY DISABLED

BRESHA SERENITY HOUSE II (0016381) DEPHENIA CONLEY Type: AFH DEVELOPMENTALLY DISABLED (262) 880-6856 Class: 2115 YOUT ST EMOTIONALLY DISTURBED/MENTAL RACINE WI 53402 DEPHENIA CONLEY Gender - Capacity: M/F - 4 DEPHENIA CONLEY 2115 YOUT ST Low/High rate: 10,370/12,000 PHYSICALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 02/16/2017 BRIGHTER DAY AFH (0014989) BRIGHTER DAY AFH LLC Type: AFH ALCOHOL/DRUG DEPENDENT (262) 497-4951 Class: 1928 NEPTUNE AVENUE DEVELOPMENTALLY DISABLED RACINE WI 53404 DEANNA RINZ Gender - Capacity: M/F - 4 (262) 664-3360 DEANNA RINZ 1102 YOUT STREET Low/High rate: 3,000/12,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53402 Initial License: 04/03/2014 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL

BRIGHTER DAY AFH CARLTON (0017376) BRIGHTER DAY AFH LLC Type: AFH HCBS COMPLIANT (262) 497-4951 Class: 555 CARLTON DRIVE ADVANCED AGED RACINE WI 53402 DEANNA RINZ Gender - Capacity: M/F - 4 DEANNA RINZ 1928 NEPTUNE AVENUE Low/High rate: 4,500/12,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53404 Initial License: 03/19/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL TRAUMATIC BRAIN INJURY BRIGHTER DAY AFH TOO (0015406) BRIGHTER DAY AFH LLC Type: AFH ADVANCED AGED (262) 497-4951 Class: 3435 ERIE STREET ALCOHOL/DRUG DEPENDENT RACINE WI 53402 DEANNA RINZ Gender - Capacity: M/F - 4 (262) 456-0092 DEANNA RINZ 1928 NEPTUNE AVENUE Low/High rate: 3,000/12,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 12/15/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

CAMELLIA HOMES-MAGNOLIA HOUSE (0016236) CAMELLIA HOMES Type: AFH HCBS COMPLIANT (262) 497-1550 Class: 4101 SHADOW LN ADVANCED AGED RACINE WI 53405 LAURI ROGERS Gender - Capacity: M/F - 4 (262) 497-1550 LAURI ROGERS PO BOX 85893 Low/High rate: 4,000/6,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53408 Initial License: 09/08/2016 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 8 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

CARE AND COMFORT 2 ADULT FAMILY HOME (0016290) CARE AND COMFORT ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (847) 344-9901 Class: 6111 E WIND LAKE RD ALCOHOL/DRUG DEPENDENT UNION GROVE WI 53182 Jessica Schoo Gender - Capacity: M/F - 4 (262) 895-0113 Jessica Schoo 6111 E WIND LAKE RD Low/High rate: 6,080/7,130 DEVELOPMENTALLY DISABLED County: RACINE UNION GROVE WI 53182 Initial License: 12/13/2016 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY CARE AND COMFORT ADULT FAMILY HOME LLC (001506 CARE AND COMFORT ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (847) 344-9901 Class: 6109 E WIND LAKE ROAD ALCOHOL/DRUG DEPENDENT UNION GROVE WI 53182 Jessica Schoo Gender - Capacity: M/F - 4 (262) 895-0152 jessica Schoo 6109 E WIND LAKE ROAD Low/High rate: 6,080/6,080 DEVELOPMENTALLY DISABLED County: RACINE UNION GROVE WI 53182 Initial License: 05/13/2014 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY CARE HOME (0009850) MARSHA HARRINGTON Type: AFH DEVELOPMENTALLY DISABLED 3820 ROYAL OAKS DR (262) 554-8022 Class: MOUNT PLEASANT WI 53406 MARSHA HARRINGTON Gender - Capacity: M/F - 4 (262) 554-8022 MARSHA HARRINGTON PO BOX 081464 Low/High rate: 4,197/7,969 County: RACINE RACINE WI 53408-1464 Initial License: 01/21/2003

CARIBE ASSISTED LIVING II (0016684) CARIBE ASSISTED LIVING II LLC Type: AFH HCBS COMPLIANT (414) 745-0216 Class: 1435 DOUGLAS AVE ADVANCED AGED RACINE WI 53404 SUHER MOHAMED Gender - Capacity: M/F - 4 (262) 412-5937 SUHER MOHAMED 1419 SUPERIOR STREET Low/High rate: 8,850/10,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 07/05/2017 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY CARIBE ASSISTED LIVING LLC (0015001) CARIBE ASSISTED LIVING, LLC Type: AFH HCBS COMPLIANT (414) 745-0216 Class: 1415 SUPERIOR STREET ADVANCED AGED RACINE WI 53402 SUHER MOHAMED Gender - Capacity: M/F - 4 (414) 745-0216 SUHER MOHAMED 1419 SUPERIOR STREET Low/High rate: 8,500/10,850 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 07/22/2014 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY Association Approval: WALA CARING HEARTS AFH (0015586) Alexandra Thomas Type: AFH ADVANCED AGED (262) 989-0047 Class: 2826 Arlington Avenue DEVELOPMENTALLY DISABLED Racine WI 53403 Alexandra Thomas Gender - Capacity: M/F - 3 (262) 989-0047 Thomas Alexandra 141 Main Street Unit 122 Low/High rate: 3,000/10,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE Racine WI 53403 Initial License: 02/11/2016 IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TRAUMATIC BRAIN INJURY CARING HEARTS AFH 2 (0018405) Alexandra Thomas Type: AFH HCBS COMPLIANT (262) 989-0047 Class: 928 DELAMERE AVENUE ADVANCED AGED RACINE WI 53403 ALEXANDRA THOMAS Gender - Capacity: M/F - 4 (262) 989-0047 ALEXANDRA THOMAS 928 DELAMERE AVE Low/High rate: 3,000/10,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 02/08/2021 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY CEDAR HOME (0012080) CRABTREE RESIDENTIAL LIVING INC Type: AFH DEVELOPMENTALLY DISABLED 316 S PERKINS (262) 909-4344 Class: BURLINGTON WI 53105 JEFFREY CRABTREE Gender - Capacity: M - 4 (262) 653-9923 JEFFREY CRABTREE PO BOX 580393 Low/High rate: 4,500/6,000 County: RACINE PLEASANT PRAIRIE WI 53158 Initial License: 08/30/2007

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 9 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

CELESTIAL TOUCH HOME HEALTH CARE LLC (0016993) CELESTIAL TOUCH HOME HEALTH CARE LLC Type: AFH ADVANCED AGED (262) 705-3602 Class: 3516 S KENNEDY DR DEVELOPMENTALLY DISABLED STURTEVANT WI 53177 CHINYERE UCHEGBU Gender - Capacity: M/F - 4 (262) 583-2113 CHINYERE UCHEGBU 3516 S KENNEDY DR Low/High rate: 4,250/6,250 PHYSICALLY DISABLED County: RACINE STURTEVANT WI 53177 Initial License: 01/25/2018 TERMINALLY ILL CHARMING HOUSE II (THE) (0014105) HANDS OF HOPE RESIDENTIAL LLC Type: AFH HCBS COMPLIANT (262) 994-9456 Class: 1509 ROOSEVELT AVE ADVANCED AGED RACINE WI 53406 MELINDA THOMPSON Gender - Capacity: M/F - 4 (262) 456-1751 MELINDA THOMPSON 1429 OREGON STREET Low/High rate: 3,552/5,250 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 04/26/2012 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY CHESAPEAKE ADULT FAMILY HOME (0017771) ANCHOR MINISTRIES INC Type: AFH HCBS COMPLIANT (262) 770-3344 Class: 6618 CHESAPEAKE RD DEVELOPMENTALLY DISABLED RACINE WI 53406 MICHELE MCGARRY Gender - Capacity: F - 4 (262) 676-3309 MICHELE MCGARRY 4900 SPRING ST STE 203 Low/High rate: 4,600/4,600 PUBLIC FUNDING County: RACINE RACINE WI 53406 Initial License: 09/19/2019 CHESTNUT HOME (0017632) INDEPENDENT ABILITIES LLC Type: AFH HCBS COMPLIANT (262) 455-5449 Class: 124 BAY RIDGE LN ADVANCED AGED BURLINGTON WI 53105 STEVEN KOELLNER Gender - Capacity: M - 4 (262) 597-5015 STEVEN KOELLNER 9211 66TH ST Low/High rate: 3,800 DEVELOPMENTALLY DISABLED County: RACINE KENOSHA WI 53142 Initial License: 06/24/2019 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY COMMUNITY PATHWAYS LLC RUBY HOUSE II (0012635) COMMUNITY PATHWAYS LLC Type: AFH HCBS COMPLIANT (262) 639-6252 Class: 3908 RUBY AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53402 LISA WALKER Gender - Capacity: M/F - 4 (262) 639-6252 LISA WALKER PO BOX 044211 Low/High rate: 4,245/4,245 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53402 Initial License: 12/18/2008 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

COMMUNITY PATHWAYS LLC VICTORY HOUSE I (0013129 COMMUNITY PATHWAYS LLC Type: AFH HCBS COMPLIANT (262) 639-6252 Class: 3744 DOUGLAS AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53402 LISA WALKER Gender - Capacity: M/F - 4 (262) 639-6242 LISA WALKER PO BOX 044211 Low/High rate: 5,080/5,080 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 02/08/2010 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PREGNANT WOMEN/COUNSELLING PUBLIC FUNDING TRAUMATIC BRAIN INJURY COMMUNITY PATHWAYS LLC VICTORY HOUSE II (001369 COMMUNITY PATHWAYS LLC Type: AFH HCBS COMPLIANT (262) 930-0483 Class: 3736 DOUGLAS AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53402 LISA WALKER Gender - Capacity: M/F - 4 (262) 639-0264 LISA WALKER P O BOX 044211 Low/High rate: 5,500/6,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 05/05/2011 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 10 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

COMMUNITY PATHWAYS RUBY HOUSE I (0012402) COMMUNITY PATHWAYS LLC Type: AFH HCBS COMPLIANT (262) 639-6252 Class: 3906 RUBY AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53402 LISA WALKER Gender - Capacity: M/F - 4 (262) 930-0483 LISA WALKER PO BOX 044211 Low/High rate: 4,245/4,245 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53402 Initial License: 06/02/2008 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY COMMUNITY TIES (0013714) TRENNIE EPPS Type: AFH HCBS COMPLIANT (262) 412-7477 Class: 3622 SOUTHWOOD DRIVE ADVANCED AGED RACINE WI 53406 TRENNIE EPPS Gender - Capacity: M/F - 3 (262) 822-0174 TRENNIE EPPS 818 HAYES AVE Low/High rate: 4,000/7,200 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 06/30/2011 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM COMPASSIONET & CARE 1 (0013232) COMPASSIONET & CARE LLC Type: AFH HCBS COMPLIANT (262) 634-0712 Class: 433 GRAHAM ST DEVELOPMENTALLY DISABLED RACINE WI 53405 MARIA D RODRIGUEZ Gender - Capacity: M/F - 4 (262) 634-0712 MARIA D RODRIGUEZ 2035 LATHROP AVE Low/High rate: 4,845/6,000 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE RACINE WI 53405 Initial License: 05/18/2010 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

COMPASSIONET & CARE LLC II (0013655) COMPASSIONET & CARE LLC Type: AFH HCBS COMPLIANT (262) 880-8938 Class: 1400 S WISCONSIN AVE DEVELOPMENTALLY DISABLED RACINE WI 53403 MARIA RODRIGUEZ Gender - Capacity: M/F - 4 (262) 456-0880 MARIA RODRIGUEZ 2035 LATHROP AVE Low/High rate: 4,845/6,000 TRAUMATIC BRAIN INJURY County: RACINE RACINE WI 53405 Initial License: 03/31/2011 COUNTRY MEADOWS FAMILY CARE ANGEL HOUSE (0014 COUNTRY MEADOWS FAMILY CARE LLC Type: AFH HCBS COMPLIANT (414) 397-9425 Class: 13207 HWY G DEVELOPMENTALLY DISABLED CALEDONIA WI 53108 ANN HEDRINGTON Gender - Capacity: M/F - 4 (262) 878-3982 ANN HEDRINGTON 2824 65TH DRIVE Low/High rate: 4,235/5,245 PUBLIC FUNDING County: RACINE FRANKSVILLE WI 53126 Initial License: 03/20/2014 COUNTRY MEADOWS FAMILY CARE LLC (0013311) COUNTRY MEADOWS FAMILY CARE LLC Type: AFH DEVELOPMENTALLY DISABLED (414) 397-9425 Class: 4125 16TH ST EMOTIONALLY DISTURBED/MENTAL RACINE WI 53405 ANN HEDRINGTON Gender - Capacity: M/F - 4 (262) 456-2264 ANN HEDRINGTON 18012 65TH CT Low/High rate: 15,000/17,065 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE FRANKSVILLE WI 53126 Initial License: 06/24/2010 PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY COUNTRY MEADOWS FAMILY CARE LLC (0013085) COUNTRY MEADOWS FAMILY CARE LLC Type: AFH HCBS COMPLIANT (262) 878-1018 Class: 2824 65TH DR DEVELOPMENTALLY DISABLED FRANKSVILLE WI 53126 ANN HEDRINGTON Gender - Capacity: M/F - 4 (262) 397-9425 ANN HEDRINGTON 18012 65TH CT Low/High rate: 3,994/4,127 PUBLIC FUNDING County: RACINE FRANKSVILLE WI 53126 Initial License: 12/17/2009 Association Approval: WALA COZY AURORA ADULT FAMILY HOME LLC (0017125) COZY AURORA ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 939-3666 Class: 2719 MARYLAND AVE DEVELOPMENTALLY DISABLED RACINE WI 53403 PARIT PATEL Gender - Capacity: M/F - 4 (262) 939-3666 PARIT PATEL 2054 KEARNEY AVE Low/High rate: 6,500/8,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 07/25/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED CYPRESS HOME (0013354) CRABTREE RESIDENTIAL LIVING Type: AFH HCBS COMPLIANT (262) 653-9923 Class: 208 EDWARDS ST ADVANCED AGED BURLINGTON WI 53105 JEFF CRABTEEE Gender - Capacity: M - 4 (262) 653-9923 JEFF CRABTREE P O BOX 580393 Low/High rate: 4,500/5,500 DEVELOPMENTALLY DISABLED County: RACINE PLEASANT PRAIRIE WI 53158 Initial License: 12/22/2010 EMOTIONALLY DISTURBED/MENTAL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 11 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

DAVIS PLACE (0013014) CORNELIOUS HOME LLC Type: AFH HCBS COMPLIANT (262) 637-3338 Class: 1009 DAVIS PL ADVANCED AGED RACINE WI 53403 MARY CORNELIOUS Gender - Capacity: M/F - 4 (262) 456-6747 MARY CORNELIOUS 1611 W 6 TH ST Low/High rate: 3,000/3,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53404 Initial License: 10/14/2009 IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING

DELAMERES PLACE TO CALL HOME AFGH LLC (0017114) DELAMERES PLACE TO CALL HOME AFGH LLC Type: AFH ADVANCED AGED (262) 902-9790 Class: 1021 DELAMERE AVE DEVELOPMENTALLY DISABLED RACINE WI 53403 MELINDA THOMPSON Gender - Capacity: M/F - 3 (262) 902-9790 MELINDA THOMPSON 4140 MANHATTAN DRIVE Low/High rate: 5,700/7,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53402 Initial License: 04/17/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY DESTINY ADULT FAMILY HOME I (0009607) DESTINY ADULT FAMILY HOMES LLC Type: AFH HCBS COMPLIANT (262) 633-3066 Class: 2419 JEAN AVE ADVANCED AGED RACINE WI 53404 HELEN CLARK Gender - Capacity: M/F - 4 (262) 633-3066 MELISSA SOTO PO BOX 085502 Low/High rate: 3,000/7,500 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53408 Initial License: 04/09/2002 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

DESTINY ADULT FAMILY HOME II (0010067) DESTINY ADULT FAMILY HOMES LLC Type: AFH HCBS COMPLIANT (262) 633-3066 Class: 1009 MAYFAIR DR ADVANCED AGED RACINE WI 53402 Helen Clark Gender - Capacity: M/F - 4 (262) 681-2325 Helen Clark PO BOX 085502 Low/High rate: 3,000/8,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53408 Initial License: 04/21/2003 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DESTINY ADULT FAMILY HOME III (0012075) DESTINY ADULT FAMILY HOMES LLC Type: AFH HCBS COMPLIANT (262) 559-6543 Class: 1011 MAYFAIR DR ADVANCED AGED RACINE WI 53402 Helen Clark Gender - Capacity: M/F - 3 (262) 308-1290 MELISSA SOTO PO BOX 085502 Low/High rate: 3,500/8,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53408 Initial License: 10/03/2007 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING TRAUMATIC BRAIN INJURY DESTINY ADULT FAMILY HOMES V (0015604) DESTINY ADULT FAMILY HOMES LLC Type: AFH HCBS COMPLIANT (414) 559-6543 Class: 2301 ROMAYNE AVE UPPER ALCOHOL/DRUG DEPENDENT RACINE WI 53408 HENDERSON MACLIN Gender - Capacity: M/F - 3 (262) 619-0656 HENDERSON CLARK MACLIN PO BOX 085502 Low/High rate: 4,000/8,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53408 Initial License: 06/04/2015 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 12 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

DESTINY AFH LLC IV (0013920) DESTINY ADULT FAMILY HOMES LLC Type: AFH HCBS COMPLIANT () - Class: 2301 ROMAYNE ADVANCED AGED RACINE WI 53404 HELEN CLARK MACLIN Gender - Capacity: M/F - 4 (262) 308-1290 MELISSA SOTO PO BOX 085502 Low/High rate: 3,500/8,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53408 Initial License: 01/19/2012 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY DIVINE LIVING (0018019) DIVINE LIVING Type: AFH HCBS COMPLIANT (262) 497-8043 Class: 817 ROMAYNE AVENUE ADVANCED AGED RACINE WI 53402 SHERRA VINSON Gender - Capacity: M/F - 4 (262) 770-4916 SHERRA VINSON 817 ROMAYNE AVENUE Low/High rate: 3,500/15,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 05/06/2020 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY DOLPHIN HOUSE A LLC (0015101) DOLPHIN HOUSE A LLC Type: AFH HCBS COMPLIANT (262) 895-6666 Class: 506A STEPHANIE STREET ADVANCED AGED BURLINGTON WI 53105 MELINDA J DOLPHIN Gender - Capacity: M/F - 4 (262) 895-6666 MELINDA J DOLPHIN 4525 GUNDERSON ROAD Low/High rate: 5,500/7,000 DEVELOPMENTALLY DISABLED County: RACINE WATERFORD WI 53185 Initial License: 11/10/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

DOLPHIN HOUSE B LLC (0015100) DOLPHIN HOUSE B LLC Type: AFH HCBS COMPLIANT (262) 895-6666 Class: 506B STEPHANIE STREET ADVANCED AGED BURLINGTON WI 53105 MELINDA J DOLPHIN Gender - Capacity: M/F - 4 (262) 895-6666 MELINDA DOLPHIN 4525 GUNDERSON ROAD Low/High rate: 5,500/7,000 DEVELOPMENTALLY DISABLED County: RACINE WATERFORD WI 53185 Initial License: 11/10/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

DURAND ADULT FAMILY HOME II LLC (0015129) DURAND ADULT FAMILY HOME II LLC Type: AFH HCBS COMPLIANT (262) 939-3666 Class: 6437 DURAND AVE ADVANCED AGED MT PLEASANT WI 53406 PARIT PATEL Gender - Capacity: M/F - 4 (262) 000-0000 PARIT PATEL 2054 KEARNEY AVENUE Low/High rate: 6,500/8,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 08/05/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING

DURAND ADULT FAMILY HOME LLC (0014928) DURAND ADULT FAMILY HOME, LLC Type: AFH HCBS COMPLIANT (262) 939-3666 Class: 6439 DURAND AVENUE ADVANCED AGED MT PLEASANT WI 53406 PARIT PATEL Gender - Capacity: M/F - 4 (262) 939-3666 PARIT PATEL 2054 KEARNEY AVENUE Low/High rate: 6,500/8,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 01/28/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 13 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

EAGLE LAKE MANOR (0017036) JAMES CARES LLC Type: AFH HCBS COMPLIANT (262) 939-3443 Class: 2720 MARSHALL SQUARE ADVANCED AGED KANSASVILLE WI 53139 DUSTIN SVENDSEN Gender - Capacity: M/F - 4 (262) 864-4322 REBECCA BURSEK PO Box 84 Low/High rate: 133/4,000 DEVELOPMENTALLY DISABLED County: RACINE UNION GROVE WI 53182 Initial License: 05/24/2018 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY EAGLES LANDING (0012634) AFFINITY HEALTH CARE LLC Type: AFH HCBS COMPLIANT (262) 895-3052 Class: 26516 NORDIC RIDGE DR ADVANCED AGED WIND LAKE WI 53185 THOMAS R SCHILLING Gender - Capacity: M/F - 4 (262) 895-6691 THOMAS SCHILLING 8208 RACINE AVE Low/High rate: 4,500/6,500 DEVELOPMENTALLY DISABLED County: RACINE WIND LAKE WI 53185 Initial License: 05/26/2009 EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING TRAUMATIC BRAIN INJURY Association Approval: WALA EDGEWOOD I (0018293) ANA LIVING LLC Type: AFH HCBS COMPLIANT (262) 342-0200 Class: 584 EDGEWOOD DRIVE ADVANCED AGED BURLINGTON WI 53105 ADRIANE NELSON Gender - Capacity: M/F - 4 (262) 342-0200 ADRIANE NELSON 3508 PENINSULA DRIVE Low/High rate: 4,400/6,800 DEVELOPMENTALLY DISABLED County: RACINE BURLINGTON WI 53105 Initial License: 11/09/2020 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ELIANA HOMES CUMBERLAND PLACE AFH (0016651) A CLEARER VISION LLC DBA ELIANNA HOMES V Type: AFH ADVANCED AGED (262) 989-2366 Class: 4945 CUMBERLAND ROAD DEVELOPMENTALLY DISABLED MOUNT PLEASANT WI 53405 GAYLE L MILLIS Gender - Capacity: M/F - 4 (262) 989-2366 GAYLE L MILLIS 3034 W STATESMEN WAY APT 103 Low/High rate: 5,600/6,400 EMOTIONALLY DISTURBED/MENTAL County: RACINE FRANKLIN WI 53132 Initial License: 07/05/2017 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ELIZABETH I (0018080) ANA LIVING LLC Type: AFH ADVANCED AGED (262) 342-0200 Class: 516 ELIZABETH STREET DEVELOPMENTALLY DISABLED WATERFORD WI 53185 ADRIANE NELSON Gender - Capacity: M/F - 4 (262) 342-0200 ADRIANE NELSON 3508 PENINSULA DRIVE Low/High rate: 4,400/6,800 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE BURLINGTON WI 53105 Initial License: 06/30/2020 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ELIZABETH II (0018079) ANA LIVING LLC Type: AFH HCBS COMPLIANT (262) 342-0200 Class: 518 ELIZABETH STREET ADVANCED AGED WATERFORD WI 53185 ADRIANE NELSON Gender - Capacity: M/F - 4 (262) 342-0200 ADRIANE NELSON 3508 PENINSULA DRIVE Low/High rate: 4,400/6,800 DEVELOPMENTALLY DISABLED County: RACINE BURLINGTON WI 53105 Initial License: 06/30/2020 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ELIZABETH III (0016724) ANA LIVING LLC Type: AFH DEVELOPMENTALLY DISABLED (262) 342-6928 Class: 106 S 3RD STREET EMOTIONALLY DISTURBED/MENTAL WATERFORD WI 53185 ADRIANE NELSON Gender - Capacity: M/F - 4 (262) 342-6928 ADRIANE NELSON PO BOX 532 Low/High rate: 4,200/5,500 PHYSICALLY DISABLED County: RACINE BURLINGTON WI 53105 Initial License: 07/27/2017 ELIZABETH IV (0017329) ANA LIVING LLC Type: AFH ADVANCED AGED (262) 342-0200 Class: 308 ELIZABETH ST DEVELOPMENTALLY DISABLED WATERFORD WI 53185 ADRIANE NELSON Gender - Capacity: M/F - 4 (262) 342-0200 ADRIANE NELSON PO Box 532 Low/High rate: 4,400/6,800 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE BURLINGTON WI 53105 Initial License: 12/13/2018 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY ELM HOME (0012870) CRABTREE RESIDENTIAL LIVING INC Type: AFH DEVELOPMENTALLY DISABLED 8339 B FISHMAN RD (262) 909-4344 Class: BURLINGTON WI 53105 JEFFREY CRABTREE Gender - Capacity: M - 4 (262) 653-9923 MACK CRABTREE PO BOX 580393 Low/High rate: 4,500/7,200 County: RACINE PLEASANT PRAIRIE WI 53158 Initial License: 12/03/2009

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 14 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

ENDLESS CARE LLC (0016503) ENDLESS CARE LLC Type: AFH ADVANCED AGED (262) 504-9450 Class: 1236 BLUFF AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53403 ESTELLE L BARLOW Gender - Capacity: M/F - 4 (262) 504-9450 ESTELLE L BARLOW PO BOX 85151 Low/High rate: 3,000/10,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53406 Initial License: 05/02/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PREGNANT WOMEN/COUNSELLING PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY EXCEL (0012795) VONDA K BROWN Type: AFH HCBS COMPLIANT (262) 822-7961 Class: 2220 SUMMIT AVE ADVANCED AGED RACINE WI 53404 VONDA BROWN Gender - Capacity: M/F - 4 (262) 995-7373 VONDA BROWN 141 OHIO ST Low/High rate: 4,265/5,130 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 06/25/2009 EMOTIONALLY DISTURBED/MENTAL TRAUMATIC BRAIN INJURY EXCEL FOUR (0015035) VONDECAIR BROWN Type: AFH HCBS COMPLIANT (262) 822-7961 Class: 139 OHIO STREET DEVELOPMENTALLY DISABLED RACINE WI 53405 VONDECAIR BROWN Gender - Capacity: M/F - 4 (262) 456-6289 VONDECAIR BROWN 141 OHIO ST Low/High rate: 3,940/5,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53405 Initial License: 04/22/2014 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY EXCEL R3 (0016698) JASMINE MALONE Type: AFH DEVELOPMENTALLY DISABLED (262) 383-1443 Class: 2019 GREEN ST LOWER EMOTIONALLY DISTURBED/MENTAL RACINE WI 53402 JASMINE MALONE Gender - Capacity: M/F - 4 (262) 800-1384 JASMINE MALONE 2019 GREEN ST UPPER Low/High rate: 5,200/6,800 PHYSICALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 11/27/2017 TRAUMATIC BRAIN INJURY EXCEL SIX (0015750) VONDECAIR BROWN Type: AFH HCBS COMPLIANT (262) 822-7961 Class: 2040 CASE AVE DEVELOPMENTALLY DISABLED RACINE WI 53405 VONDECAIR BROWN Gender - Capacity: M/F - 4 (262) 583-1327 VONDECAIR BROWN 141 OHIO ST Low/High rate: 11,700/11,796 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53405 Initial License: 01/21/2016 PUBLIC FUNDING TRAUMATIC BRAIN INJURY EXCEL THREE (0013704) VONDA BROWN Type: AFH HCBS COMPLIANT (262) 822-7961 Class: 4300 MARYLAND AVE ADVANCED AGED RACINE WI 53405 VONDA BROWN Gender - Capacity: M/F - 4 (262) 995-7373 VONDA BROWN 141 OHIO ST Low/High rate: 4,500/5,301 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 06/30/2011 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY EXCEL TWO (0013125) VONDA BROWN Type: AFH DEVELOPMENTALLY DISABLED (262) 822-7961 Class: 2051 CHARLES ST EMOTIONALLY DISTURBED/MENTAL RACINE WI 53402 VONDA BROWN Gender - Capacity: M/F - 4 (262) 260-8825 VONDA BROWN 141 OHIO ST Low/High rate: 11,700/11,796 PHYSICALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 12/17/2009 PUBLIC FUNDING TRAUMATIC BRAIN INJURY FAITH COMMUNITY ADULT GROUP HOME (0014776) FAITH COMMUNITY ADULT GROUP HOME LLC Type: AFH HCBS COMPLIANT (262) 989-0232 Class: 5025 MARYLAND AVE ADVANCED AGED RACINE WI 53406 DONALD W WATSON Gender - Capacity: M/F - 4 (262) 456-6535 DYLAND WEATHER 115 ALGONQUIN STREET Low/High rate: 4,582/4,950 ALCOHOL/DRUG DEPENDENT County: RACINE BATTLE CREEK MI 49037 Initial License: 09/25/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 15 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

FAITH GROUP HOME (0013990) FAITH COMMUNITY ADULT GROUP HOME LLC Type: AFH ADVANCED AGED (262) 989-0232 Class: 3317 OAKWOOD DRIVE ALCOHOL/DRUG DEPENDENT RACINE WI 53406 DONALD WATSON Gender - Capacity: M/F - 4 (262) 554-3233 DYLAND WEATHER 115 ALGONQUIN STREET Low/High rate: 4,500/4,900 DEVELOPMENTALLY DISABLED County: RACINE BATTLE CREEK MI 49037 Initial License: 01/19/2012 EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING FORGET ME NOT (0016613) FORGET ME NOT LLC Type: AFH HCBS COMPLIANT (262) 637-4709 Class: 1426 CARLISLE AVE ADVANCED AGED RACINE WI 53404 EUREKA BELL Gender - Capacity: M/F - 4 (262) 637-4709 EUREKA BELL 1426 CARLISLE AVE Low/High rate: 3,000/10,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 05/25/2017 EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING TRAUMATIC BRAIN INJURY FORGET ME NOT II AFH LLC (0018171) FORGET ME NOT II AFH LLC Type: AFH HCBS COMPLIANT (262) 412-5114 Class: 3342 SOUTHWOOD DRIVE ADVANCED AGED RACINE WI 53406 EUREKA BELL Gender - Capacity: M/F - 4 (262) 412-5114 EUREKA BELL 1331 KEWAUNEE STREET Low/High rate: DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 08/20/2020 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY GALL FAMILY CARE HOME (0008955) GALL FAMILY CARE HOME Type: AFH HCBS COMPLIANT (262) 534-4018 Class: 1315 SCHNEIDER LN DEVELOPMENTALLY DISABLED BURLINGTON WI 53105 RENEE GALL Gender - Capacity: M/F - 4 (262) 534-4018 RENEE GALL 1315 SCHNEIDER LN Low/High rate: 1,800/3,500 County: RACINE BURLINGTON WI 53105 Initial License: 02/23/2000 GIFTED HANDS ADULT LIVING FACILITIES LLC (0018102) GIFTED HANDS ADULT LIVING FACILITIES LLC Type: AFH HCBS COMPLIANT (262) 631-0234 Class: 1556 KEARNEY AVENUE LOWER ADVANCED AGED RACINE WI 53405 DELITHA BOSTICK Gender - Capacity: M/F - 4 (262) 631-0234 DELITHA BOSTICK 1556 KEARNEY AVENUE LOWER Low/High rate: 3,500/15,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53405 Initial License: 05/26/2020 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY GOLDEN AGE CARE (1743) (0014855) GOLDEN AGE CARE, LLC Type: AFH HCBS COMPLIANT (262) 770-4084 Class: 1743 SPRING STREET ADVANCED AGED RACINE WI 53404 ROMAN YISSAK Gender - Capacity: M/F - 4 (262) 770-4084 ROMAN YISSAK 2310 S GREEN BAY RD STE C #297 Low/High rate: 4,200/4,650 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 11/26/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY GOLDEN AGE CARE (1745) (0014856) GOLDEN AGE CARE, LLC Type: AFH HCBS COMPLIANT (262) 770-4084 Class: 1745 SPRING STREET ADVANCED AGED RACINE WI 53404 ROMAN YISSAK Gender - Capacity: M/F - 4 (262) 770-4084 ROMAN YISSAK 2310 S GREEN BAY RD STE C #297 Low/High rate: 4,200/4,650 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 11/26/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 16 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

GOLDEN AGE CARE 1663 (0015594) Golden Age Care 1661 LLC Type: AFH ADVANCED AGED (414) 739-1609 Class: 1663 Village Drive ALCOHOL/DRUG DEPENDENT Racine WI 53406 Abraham Isaac Gender - Capacity: M/F - 4 (262) 770-4084 Abraham Isaac 2310 S Green Bay Rd Ste C #297 Low/High rate: 4,200/4,650 DEVELOPMENTALLY DISABLED County: RACINE Racine WI 53406 Initial License: 08/19/2015 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL GOOD LIFE AT HOME (0017728) GOOD LIFE AT HOME Type: AFH HCBS COMPLIANT (414) 412-9299 Class: 2424 LORAINE AVE ADVANCED AGED RACINE WI 53404 CHAUNTEL VINSON Gender - Capacity: M/F - 4 (414) 979-6995 CHAUNTEL VINSON PO BOX 044016 Low/High rate: 4,000/8,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 07/12/2019 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY GOOD LIFE AT HOME (0017982) GOOD LIFE AT HOME LLC Type: AFH HCBS COMPLIANT (262) 412-9299 Class: 2301 WILLIAM STREET ADVANCED AGED RACINE WI 53404 CHAUNTEL VINSON Gender - Capacity: M/F - 4 (262) 822-4603 CHAUNTEL VINSON PO BOX 044016 Low/High rate: 4,000/8,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 08/20/2020 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY GREEN BAY ADULT FAMILY HOME (0016128) GREEN BAY ADULT FAMILY HOME Type: AFH ADVANCED AGED (262) 880-1873 Class: 1111 N GREEN BAY RD DEVELOPMENTALLY DISABLED MOUNT PLEASANT WI 53406 COURTNEY CONNER Gender - Capacity: M/F - 4 (262) 880-1873 COURTNEY CONNER 2706 CHICORY RD Low/High rate: 6,000/ EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 05/31/2016 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY GUNDERSON FAMILY HOME (390164) GUNDERSON FAMILY HOME Type: AFH HCBS COMPLIANT (262) 878-0810 Class: 707 224TH AVE DEVELOPMENTALLY DISABLED KANSASVILLE WI 53139 GLENN & KATHY GUNDERSON Gender - Capacity: M/F - 4 (262) 878-0810 GLENN GUNDERSON 707 224TH AVE Low/High rate: 5,200/9,000 County: RACINE KANSASVILLE WI 53139 Initial License: 04/01/1998 HARMONY HOME ON NEWMAN LLC (0016680) HARMONY HOME ON NEWMAN LLC Type: AFH ADVANCED AGED (414) 687-2088 Class: 448 NEWMAN RD DEVELOPMENTALLY DISABLED MOUNT PLEASANT WI 53406 ANN CIOMBOR Gender - Capacity: M/F - 4 (414) 687-2088 ANN CIOMBOR 2706 CHICORY RD Low/High rate: 6,000/ EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53406 Initial License: 07/20/2017 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY HEALING HANDZ (0016644) HEALING HANDZ HOMECARE LLC Type: AFH ALCOHOL/DRUG DEPENDENT (702) 301-2364 Class: 3023 GILSON STREET DEVELOPMENTALLY DISABLED RACINE WI 53403 JOREENA COBB Gender - Capacity: M/F - 3 (702) 301-2364 JOREENA COBB 3023 GILSON STREET Low/High rate: 5,000/5,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 06/16/2017 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 17 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

HEART 2 HEART GROUP HOME LLC (0017879) HEART 2 HEART GROUP HOME LLC Type: AFH HCBS COMPLIANT (262) 902-9444 Class: 1001 LAYARD AVENUE DEVELOPMENTALLY DISABLED RACINE WI 53402 JULIE VELASQUEZ Gender - Capacity: M/F - 3 (262) 902-9444 JULIE VELASQUEZ 1001 LAYARD AVENUE Low/High rate: 4,000/6,000 County: RACINE RACINE WI 53402 Initial License: 01/31/2020 HEMLOCK HOME (0017644) INDEPENDENT ABILITIES LLC Type: AFH HCBS COMPLIANT (262) 455-5449 Class: 848 WEILER RD ADVANCED AGED BURLINGTON WI 53105 STEVEN KOELLNER Gender - Capacity: M/F - 4 (262) 597-5555 STEVEN KOELLNER 9211 66TH ST Low/High rate: 3,800 DEVELOPMENTALLY DISABLED County: RACINE KENOSHA WI 53142 Initial License: 08/01/2019 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY HERITAGE HOMES LIVING LLC (0015046) HERITAGE HOMES LIVING, LLC Type: AFH HCBS COMPLIANT (262) 939-5000 Class: 3711 LATHROP AVE ADVANCED AGED RACINE WI 53405 RACHEL JOHNSON Gender - Capacity: M/F - 4 (262) 554-6239 RACHEL JOHNSON 1209 NEWMAN ROAD Low/High rate: 5,448/8,548 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 05/28/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

HOME OF HFL LLC (0016341) PATSY J MUNOZ Type: AFH ADVANCED AGED (262) 554-4715 Class: 4119 LASALLE STREET DEVELOPMENTALLY DISABLED RACINE WI 53402 PATSY MUNOZ Gender - Capacity: M/F - 4 (262) 554-4715 PATSY MUNOZ 3127 DEBRA LN Low/High rate: 6,000/12,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 01/30/2017 IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY HOMEWOOD ADULT FAMILY HOME LLC (0015517) HOMEWOOD ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 939-3666 Class: 3339 MONARCH DRIVE DEVELOPMENTALLY DISABLED RACINE WI 53403 AMIT PATEL Gender - Capacity: M/F - 4 (262) 939-3666 AMIT PATEL 2054 KEARNEY AVENUE Low/High rate: 6,500/8,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 04/08/2015 IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TRAUMATIC BRAIN INJURY HOPE AWAY FROM HOME (0014727) SHERRIAN BOYD Type: AFH HCBS COMPLIANT (262) 632-1082 Class: 3100 BARBARA DR DEVELOPMENTALLY DISABLED RACINE WI 53402 SHERRIAN BOYD Gender - Capacity: M - 4 (262) 554-7057 REGINIA JOHNSON 1939 JAY EYE SEE AV Low/High rate: 12,540/16,642 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 09/23/2013 HOUSE OF FAITH HOPE LOVE 2 (0016501) HICKS INC Type: AFH HCBS COMPLIANT (262) 488-0850 Class: 2826 ORCHARD ST ADVANCED AGED RACINE WI 53405 KEITH HICKS Gender - Capacity: M/F - 3 (262) 488-0850 KEITH HICKS 2328 VIRGINIA ST Low/High rate: 3,000/7,500 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53405 Initial License: 09/20/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY HOUSE OF LOVE LLC ADULT FAMILY HOME (0016121) THERESA LOVE TOMLIN Type: AFH ADVANCED AGED (262) 989-1629 Class: 1518 HARMONY DR DEVELOPMENTALLY DISABLED RACINE WI 53402 THERESA LOVE TOMLIN Gender - Capacity: M/F - 4 THERESA LOVE TOMLIN 1318 CENTER STREET Low/High rate: 4,000/4,750 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 06/20/2016 IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 18 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

HOWE WE NATURALLY NURTURE (0016458) NATURALLY NURTURED LLC Type: AFH HCBS COMPLIANT (262) 752-3830 Class: 2201 HOWE ST ADVANCED AGED RACINE WI 53403 CHANEL NELSON Gender - Capacity: M/F - 3 (262) 752-3830 CHANEL NELSON 1430 VILLA ST Low/High rate: 3,500/10,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 09/18/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY HUNTING FOR MORE LOVE (0016649) HUNTING FOR MORE LOVE LLC Type: AFH HCBS COMPLIANT (262) 880-6019 Class: 6 MCKINLEY AVENUE ADVANCED AGED RACINE WI 53404 Keyosha Moore Gender - Capacity: M/F - 4 (262) 880-6019 Keyosha Moore 15924 Winston Point ln Low/High rate: 3,500/5,000 DEVELOPMENTALLY DISABLED County: RACINE Houston TX 53406 Initial License: 08/09/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED I M HOME (0017102) INDEPENDENT MOVEMENT LLC Type: AFH ADVANCED AGED (262) 800-3256 Class: 1821 LINDEN AVE DEVELOPMENTALLY DISABLED RACINE WI 53403 TATREANA MAYFIELD Gender - Capacity: M/F - 4 (262) 412-6226 TATREANA MAYFIELD 1821 LINDEN AVE Low/High rate: EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 07/30/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY INDEPENDENT MOVEMENT (0015466) TATREANA MAYFIELD Type: AFH ALCOHOL/DRUG DEPENDENT (262) 412-6226 Class: 1329 KEWAUNEE STREET CORRECTIONAL CLIENTS RACINE WI 53404 TATREANA MAYFIELD Gender - Capacity: M/F - 4 (262) 930-3339 TATREANA MAYFIELD 1329 KEWAUNEE STREET Low/High rate: 4,190/4,340 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 01/21/2016 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED PREGNANT WOMEN/COUNSELLING

IVYS PLACE (0016617) HANDS OF HOPE RESIDENTIAL LLC Type: AFH ADVANCED AGED (262) 994-9756 Class: 1429 OREGON STREET DEVELOPMENTALLY DISABLED RACINE WI 53405 MELINDA THOMPSON Gender - Capacity: M/F - 3 (262) 681-2530 MELINDA THOMPSON 1429 OREGON STREET Low/High rate: 4,000/4,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53405 Initial License: 06/06/2017 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY J HARRIS HOMES (0016712) J HARRIS HOMES INC Type: AFH HCBS COMPLIANT (262) 744-4544 Class: 1114 N HILLOCK DRIVE ADVANCED AGED MOUNT PLEASANT WI 53406 INDIGO HARRIS Gender - Capacity: M/F - 4 (262) 744-4844 INDIGO HARRIS 1114 N HILLOCK DRIVE Low/High rate: 3,750/4,750 DEVELOPMENTALLY DISABLED County: RACINE MOUNT PLEASANT WI 53406 Initial License: 08/29/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY JAMES CARES LLC (0016153) JAMES CARES LLC Type: AFH HCBS COMPLIANT (262) 939-3443 Class: 2422 MARSHALL SQUARE DEVELOPMENTALLY DISABLED DOVER WI 53139 DUSTIN SVENDSEN Gender - Capacity: M/F - 4 (262) 864-2283 REBECCA BURSEK PO Box 84 Low/High rate: 3,000/7,500 PHYSICALLY DISABLED County: RACINE UNION GROVE WI 53182 Initial License: 06/13/2016 JEAN MANOR (0017128) JAMES CARES LLC Type: AFH HCBS COMPLIANT (262) 939-3443 Class: 1344 JEAN ST ADVANCED AGED UNION GROVE WI 53182 DUSTIN SVENDSEN Gender - Capacity: M/F - 4 (262) 864-4283 REBECCA BURSEK PO Box 84 Low/High rate: 3,700/5,700 DEVELOPMENTALLY DISABLED County: RACINE UNION GROVE WI 53182 Initial License: 05/10/2018 PHYSICALLY DISABLED

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 19 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

K&D ADULT FAMILY HOME LLC (0012674) K&D ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (760) 500-5908 Class: 2519 LORAINE AVE DEVELOPMENTALLY DISABLED RACINE WI 53404 MARK A GILL Gender - Capacity: M/F - 4 (262) 637-7097 LAVONDA PERKINS 35189 VIA LAGUNA Low/High rate: 160/190 EMOTIONALLY DISTURBED/MENTAL County: RACINE WINCHESTER CA 92596 Initial License: 07/01/2009 TRAUMATIC BRAIN INJURY K&D ADULT FAMILY HOMES LLC II (0013176) K&D ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (760) 500-5908 Class: 3707 10TH AVE DEVELOPMENTALLY DISABLED RACINE WI 53402 MARK A GILL Gender - Capacity: M/F - 4 (262) 637-7097 LAVONDA PERKINS 35189 VIA LAGUNA Low/High rate: 3,000/4,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE WINCHESTER CA 92596 Initial License: 02/23/2010 PUBLIC FUNDING TRAUMATIC BRAIN INJURY K&D AFH LLC #3 (0013710) K&D ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (760) 500-5908 Class: 3709 10TH AVE DEVELOPMENTALLY DISABLED RACINE WI 53402 MARK A GILL Gender - Capacity: M/F - 3 (262) 930-2925 LAVONDA PERKINS 35189 VIA LAGUNA Low/High rate: 2,500/3,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE WINCHESTER CA 92596 Initial License: 07/13/2011 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY K&D AFH LLC 4 (0016513) K&D ADULT FAMILY HOME LLC Type: AFH DEVELOPMENTALLY DISABLED (760) 500-5908 Class: 2627 JEAN AVE EMOTIONALLY DISTURBED/MENTAL RACINE WI 53404 LAVONDA PERKINS Gender - Capacity: M/F - 3 (262) 994-8319 LAVONDA PERKINS 2818 DONNA AVE Low/High rate: 3,000/4,000 TRAUMATIC BRAIN INJURY County: RACINE RACINE WI 53404 Initial License: 05/18/2017 KANSASVILLE HOUSE (0013507) VOLUNTEERS OF AMERICA WISCONSIN INC Type: AFH HCBS COMPLIANT (414) 928-5500 Class: 24710 18TH ST ADVANCED AGED KANSASVILLE WI 53139 ALISSA KEMPKEN Gender - Capacity: M/F - 4 (414) 928-5502 ALISSA KEMPKEN 1661 N WATER ST #401 Low/High rate: 7,300/9,000 CORRECTIONAL CLIENTS County: RACINE MILWAUKEE WI 53202 Initial License: 02/09/2011 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING KENWOOD KEYS INCORPORATED KENWOOD 2 (0015571 KENWOOD KEYS INC Type: AFH HCBS COMPLIANT (262) 456-1801 Class: 2903 KENWOOD DR ADVANCED AGED RACINE WI 53403 HOPE SOUTER Gender - Capacity: M/F - 4 (262) 456-4229 HOPE SOUTER PO BOX 085465 Low/High rate: 4,500/11,873 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53408 Initial License: 04/28/2015 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED KIND CARE LLC (0016364) KIND CARE LLC Type: AFH ADVANCED AGED (262) 488-1131 Class: 1901 SATURN AVE DEVELOPMENTALLY DISABLED RACINE WI 53404 DANIEL RODRIGUEZ Gender - Capacity: M/F - 4 (262) 488-1131 DANIEL RODRIGUEZ 1901 SATURN AVE Low/High rate: 4,200/6,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53404 Initial License: 07/13/2017 IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY KINZIE PLACE (0012747) KENWOOD KEYS INC Type: AFH HCBS COMPLIANT (262) 456-2388 Class: 4618 KINZIE AVE ADVANCED AGED RACINE WI 53405 HOPE SOUTER Gender - Capacity: M/F - 4 (262) 456-2388 HOPE SOUTER PO BOX 085465 Low/High rate: 4,397/5,205 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406-5465 Initial License: 04/27/2009 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED KINZIE WAY LLC (0017042) KINZIE WAY LLC Type: AFH HCBS COMPLIANT (262) 498-6640 Class: 3900 KNOLL PLACE ADVANCED AGED RACINE WI 53403 HOPE SOUTER Gender - Capacity: M/F - 4 (262) 456-1801 HOPE SOUTER PO BOX 085465 Low/High rate: 5,000/9,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53408 Initial License: 05/22/2018 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 20 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

KNOLL PLACE (0011487) KENWOOD KEYS INC Type: AFH HCBS COMPLIANT (262) 456-6640 Class: 3800 KNOLL PL ADVANCED AGED RACINE WI 53403 HOPE SOUTER Gender - Capacity: M/F - 4 (262) 456-0574 HOPE SOUTER PO BOX 085465 Low/High rate: 4,500/11,873 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53408-5465 Initial License: 05/03/2007 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED KWASIGROCH FAMILY CARE HOME (0009255) SUE KWASIGROCH Type: AFH HCBS COMPLIANT (262) 534-3355 Class: 29312 WASHINGTON AVE DEVELOPMENTALLY DISABLED ROCHESTER WI 53167 SUE KWASIGROCH Gender - Capacity: M - 4 (262) 534-3355 SUE KWASIGROCH PO BOX 661 Low/High rate: 1,500/7,000 PHYSICALLY DISABLED County: RACINE ROCHESTER WI 53167 Initial License: 08/01/2001 LIBERTY WILLOWS ADULT FAMILY HOME LLC (0016800) LIBERTY WILLOWS ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 744-5696 Class: 1824 HOLMES AVE ALCOHOL/DRUG DEPENDENT RACINE WI 53403 NAKHAKA DAVIS Gender - Capacity: M/F - 4 (262) 744-5696 NAKHAKA DAVIS 1703 HOLMES AVE Low/High rate: 5,800/6,900 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 10/17/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY Liberty Willows Adult Family Home LLC #2 (0018447) LIBERTY WILLOWS ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 744-5696 Class: 1828 Holmes Ave ADVANCED AGED Racine WI 53403 NAKHAKA DAVIS Gender - Capacity: M/F - 4 (262) 744-5696 Nakhaka Davis 3725 GREEN ST Low/High rate: ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53402 Initial License: 06/29/2021 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY Liberty Willows Adult Family Home LLC #3 (0018446) LIBERTY WILLOWS ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 744-5696 Class: 628 North St ADVANCED AGED Racine WI 53402 NAKHAKA DAVIS Gender - Capacity: - 4 (262) 744-5696 Nakhaka Davis 3725 GREEN ST Low/High rate: 5,500/7,500 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53402 Initial License: 06/29/2021 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY LIFESTYLE ADULT FAMILY HOME 1 (0010694) LIFESTYLE ADULT CARE HOMES LLC Type: AFH HCBS COMPLIANT (262) 412-7054 Class: 3620 SOVEREIGN DR ADVANCED AGED RACINE WI 53406 JACQUELINE MCRAE Gender - Capacity: M/F - 4 (262) 412-7054 JACQUELINE MCRAE P O BOX 085943 Low/High rate: 5,000/8,200 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 02/08/2010 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 21 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

LIFESTYLE ADULT FAMILY HOME 2 (0013686) LIFESTYLE ADULT CARE HOMES LLC Type: AFH HCBS COMPLIANT (262) 412-7054 Class: 3628 SOVEREIGN DR ADVANCED AGED RACINE WI 53406 JACQUELINE MCRAE Gender - Capacity: M/F - 4 (262) 412-7054 JACQUELINE MCRAE P O BOX 085943 Low/High rate: 4,000/6,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 04/04/2011 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY LIFESTYLE ADULT FAMILY HOME 3 (0013861) LIFESTYLE ADULT CARE HOMES LLC Type: AFH HCBS COMPLIANT (262) 412-7054 Class: 3614 SOVEREIGN DR ADVANCED AGED RACINE WI 53406 JACQUELINE MCRAE Gender - Capacity: M/F - 4 (262) 412-7054 JACQUELINE MCRAE P O BOX 085943 Low/High rate: 5,000/8,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 11/23/2011 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

LIFESTYLE ADULT FAMILY HOME 4 (0014696) LIFESTYLE ADULT CARE HOMES, LLC Type: AFH HCBS COMPLIANT (262) 412-7054 Class: 3616 SOVEREIGN DR ADVANCED AGED RACINE WI 53406 JACQUELINE MCRAE Gender - Capacity: M/F - 4 (262) 554-6614 JACQUELINE MCRAE PO BOX 085943 Low/High rate: 4,500/9,980 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 07/11/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LIFESTYLE ADULT FAMILY HOME 5 (0014939) LIFESTYLE ADULT CARE HOMES, LLC Type: AFH HCBS COMPLIANT (262) 412-7054 Class: 5224 ADMIRALTY DR ADVANCED AGED RACINE WI 53406 JACQUELINE MCRAE Gender - Capacity: M/F - 4 (262) 554-1934 JACQUELINE MCRAE PO BOX 085943 Low/High rate: 4,000/8,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 03/10/2014 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LILAC HOME (0017643) INDEPENDENT ABILITIES LLC Type: AFH HCBS COMPLIANT (262) 455-5449 Class: 141 DAVIDSON DR ADVANCED AGED RACINE WI 53105 STEVEN KOELLNER Gender - Capacity: M/F - 4 (262) 597-5013 STEVEN KOELLNER 9211 66TH ST Low/High rate: 3,800 DEVELOPMENTALLY DISABLED County: RACINE KENOSHA WI 53142 Initial License: 08/01/2019 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LIVE WELL ADULT FAMILY HOME LLC (0018242) LIVE WELL ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 902-9489 Class: 2809 DREXEL AVENUE ADVANCED AGED RACINE WI 53403 KEITH THOMPSON Gender - Capacity: M/F - 3 (262) 930-5257 KEDONA THOMPSON 1121 TALL OAK COURT Low/High rate: 3,300/5,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 09/16/2020 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LOETHERS HOME (0010474) ANNE & RUSSELL LOETHER Type: AFH HCBS COMPLIANT (262) 210-2230 Class: 1222 LAUREL LN DEVELOPMENTALLY DISABLED KANSASVILLE WI 53139 ANNE & RUSSELL LOETHER Gender - Capacity: M/F - 4 (262) 878-0185 ANNE & RUSSELL LOETHER 1222 LAUREL LN Low/High rate: 2,281/4,000 County: RACINE KANSASVILLE WI 53139 Initial License: 05/19/2004

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 22 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

LOVE N COMFORT GROUP HOME (0016423) LOVE N COMFORT LLC Type: AFH ADVANCED AGED (414) 610-5984 Class: 1001 CENTER ST DEVELOPMENTALLY DISABLED RACINE WI 53403 NOOR TWAM Gender - Capacity: M/F - 4 (414) 610-5984 NOOR TWAM 1001 CENTER ST Low/High rate: 8,000/9,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53403 Initial License: 02/28/2017 IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL TRAUMATIC BRAIN INJURY LOVE OF CARING LLC (0013582) LOVE OF CARING LLC Type: AFH HCBS COMPLIANT (262) 412-5219 Class: 101 HOWLAND AVE ADVANCED AGED RACINE WI 53403 NICOLE COBB Gender - Capacity: M - 4 (262) 412-5219 NICOLE COBB 1638 ECHO LANE Low/High rate: 3,500/4,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 11/14/2011 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LOVE OF CARING LLC (0014227) LOVE OF CARING LLC Type: AFH HCBS COMPLIANT (262) 412-5219 Class: 1638 ECHO LN ADVANCED AGED RACINE WI 53403 NICOLE COBB Gender - Capacity: M/F - 4 (262) 412-5219 NICOLE COBB 1638 ECHO LN Low/High rate: 3,500/4,500 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 10/16/2012 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY WAIVER CERTIFIED INDEPENDENT C LOVE OF CARING LLC DAISY AFH (0016012) LOVE OF CARING LLC Type: AFH HCBS COMPLIANT (262) 412-5219 Class: 2214 WILLIAM STREET ADVANCED AGED RACINE WI 53406 NICOLE COBB Gender - Capacity: M/F - 4 (262) 412-5219 NICOLE COBB 1638 ECHO LANE Low/High rate: 4,550/6,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53406 Initial License: 12/06/2016 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LOVE OF CARING LLC TULIP AFH (0016015) LOVE OF CARING LLC Type: AFH HCBS COMPLIANT (262) 412-5219 Class: 1834 13TH STREET ADVANCED AGED RACINE WI 53403 NICOLE COBB Gender - Capacity: M/F - 4 (262) 412-5219 NICOLE COBB 1638 ECHO LANE Low/High rate: 4,835/6,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 12/06/2016 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY LOVE TO REMEMBER LLC (0017342) LOVE TO REMEMBER LLC Type: AFH HCBS COMPLIANT (414) 491-3175 Class: 826 PARK AVENUE ADVANCED AGED RACINE WI 53403 CINMEON BOWERS Gender - Capacity: M/F - 4 (262) 456-7628 CINMEON BOWERS 815 8TH STREET APT M02 Low/High rate: 3,500/10,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53403 Initial License: 04/01/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL TRAUMATIC BRAIN INJURY MAGNOLIA HOME (0017634) INDEPENDENT ABILITIES LLC Type: AFH HCBS COMPLIANT (262) 455-5449 Class: 901 CRESTWOOD DR ADVANCED AGED BURLINGTON WI 53105 STEVEN KOELLNER Gender - Capacity: F - 4 (262) 597-5011 STEVEN KOELLNER 9211 66TH ST Low/High rate: 3,800 DEVELOPMENTALLY DISABLED County: RACINE KENOSHA WI 53142 Initial License: 06/24/2019 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 23 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

MANHATTAN HOME ADULT FAMILY GROUP HOME (00154 MANHATTAN HOME ADULT FAMILY GROUP HOM Type: AFH ADVANCED AGED (262) 902-9790 Class: 4140 MANHATTAN DRIVE DEVELOPMENTALLY DISABLED RACINE WI 53402 MELINDA THOMPSON Gender - Capacity: M/F - 4 (262) 902-9790 MELINDA THOMPSON 4140 MANHATTAN DRIVE Low/High rate: 4,000/5,700 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53402 Initial License: 12/08/2015 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED

MANNA HOUSE (THE) (0012956) MANNA HOUSE ADULT FAMILY HOME LLC (THE) Type: AFH HCBS COMPLIANT (262) 902-3338 Class: 2400 KINZIE AVE ADVANCED AGED RACINE WI 53405 BEATRICE JOHNSON Gender - Capacity: M/F - 4 (262) 637-8362 BEATRICE JOHNSON 2400 KINZIE AVE Low/High rate: 4,250/6,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 12/17/2009 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY MAPLE HOME (0012871) CRABTREE RESIDENTIAL LIVING INC Type: AFH HCBS COMPLIANT (262) 909-4344 Class: 8339 A FISHMAN RD DEVELOPMENTALLY DISABLED BURLINGTON WI 53105 JEFFREY CRABTREE Gender - Capacity: M - 4 (262) 960-2200 MACK CRABTREE PO BOX 580393 Low/High rate: 4,500/7,200 County: RACINE PLEASANT PRAIRIE WI 53158 Initial License: 08/06/2009 MARINAS GROUP HOME (0015330) LUIS GONZALEZ Type: AFH HCBS COMPLIANT (262) 945-4249 Class: 5140 KINGS CIRCLE ADVANCED AGED RACINE WI 53406 LUIS GONZALEZ Gender - Capacity: M/F - 4 (262) 456-1087 LUIS GONZALEZ 5140 KINGS CIRCLE Low/High rate: 10,000/11,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 10/30/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING

MARSHAS ADULT FAMILY HOME LLC (0017773) MARSHAS ADULT FAMILY HOME LLC Type: AFH DEVELOPMENTALLY DISABLED (262) 498-6372 Class: 3121 KEARNEY AVE EMOTIONALLY DISTURBED/MENTAL RACINE WI 53403 LISA WALKERHOUSE Gender - Capacity: M - 4 (262) 632-1993 GERALD HOUSE 3425 KENTUCKY ST Low/High rate: 3,500/4,000 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE RACINE WI 53405 Initial License: 08/08/2019 PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY MARTIN FAMILY CARE HOME (390199) MARILYN A MARTIN Type: AFH HCBS COMPLIANT (262) 878-3138 Class: 18328 SPRING ST ADVANCED AGED UNION GROVE WI 53182 MARILYN A MARTIN Gender - Capacity: M/F - 4 (262) 994-9200 MARILYN A MARTIN 18328 SPRING ST Low/High rate: 3,875/4,650 DEVELOPMENTALLY DISABLED County: RACINE UNION GROVE WI 53182 Initial License: 08/01/1998 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING MIL FAMILY CARE LLC (0015580) MIL FAMILY CARE LLC Type: AFH ADVANCED AGED (262) 939-6661 Class: 2023 GILLEN STREET DEVELOPMENTALLY DISABLED RACINE WI 53403 TARAL PATEL Gender - Capacity: M/F - 4 (262) 939-6661 TARAL PATEL 3839 BLOSSOM DRIVE Low/High rate: 2,800/9,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53406 Initial License: 01/15/2016 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING MOUNT PLEASANT HOMES LLP (0018473) MOUNT PLEASANT HOMES LLP Type: AFH HCBS COMPLIANT (262) 210-7214 Class: 1826 SAINT PATRICK STREET ADVANCED AGED RACINE WI 53404 CHRISTINE GOLDEN Gender - Capacity: M/F - 3 (262) 456-2690 CHRISTINE GOLDEN PO BOX 44132 Low/High rate: 4,000/9,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53404 Initial License: 06/08/2021 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 24 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

MOUNT PLEASANT HOMES LLP (0016430) MOUNT PLEASANT HOMES LLP Type: AFH HCBS COMPLIANT (262) 210-7214 Class: 1917 MOUNT PLEASANT ST ADVANCED AGED RACINE WI 53404-2628 Christine Golden Gender - Capacity: M/F - 3 (262) 822-4603 Christine Golden PO BOX 44132 Low/High rate: 4,000/ DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 02/23/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY NEW VISION ADULT FAMILY HOME LLC (0011964) NEW VISION ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 554-9566 Class: 7931 DANIEL CT ADVANCED AGED RACINE WI 53406 SHALANDA BEDFORD Gender - Capacity: M/F - 4 (262) 554-9566 SHALANDA BEDFORD PO BOX 085782 Low/High rate: 3,000/4,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408-5782 Initial License: 05/11/2007 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY NEW WAY ADULT FAMILY HOME #1 (0018155) JESSICA APPLEWHITE Type: AFH HCBS COMPLIANT (262) 822-9862 Class: 1852 WOODLAND AVENUE ALCOHOL/DRUG DEPENDENT RACINE WI 53403 JESSICA APPLEWHITE Gender - Capacity: M/F - 4 (262) 822-9862 JESSICA APPLEWHITE 2827 EAST FIELDSTONE WAY Low/High rate: 3,500/5,500 DEVELOPMENTALLY DISABLED County: RACINE STURTEVANT WI 53177 Initial License: 07/01/2020 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY NEW WAY OF LIVING ADULT FAMILY HOME (0017992) NEW WAY OF LIVING ADULT FAMILY HOME Type: AFH HCBS COMPLIANT (262) 822-9862 Class: 221 CHICAGO STREET ALCOHOL/DRUG DEPENDENT RACINE WI 53405 JESSICA APPLEWHITE Gender - Capacity: M/F - 4 (262) 282-0728 JESSICA APPLEWHITE 2827 E FIELDSTONE WAY UNIT2221 Low/High rate: 3,500/6,000 DEVELOPMENTALLY DISABLED County: RACINE STURTEVANT WI 53177 Initial License: 02/27/2020 EMOTIONALLY DISTURBED/MENTAL PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY OHIO ST FAMILY HOME (0010007) CYLINTIA KNIBBS Type: AFH HCBS COMPLIANT (262) 456-1246 Class: 1223 OHIO ST ADVANCED AGED RACINE WI 53405 CYLINTIA KNIBBS Gender - Capacity: M/F - 4 (262) 456-1246 CYLINTIA KNIBBS 1223 OHIO ST Low/High rate: 2,500/4,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 03/01/2004 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY OLIVER ADULT FAMILY HOME (0012467) CONNIE OLIVER Type: AFH HCBS COMPLIANT (262) 554-6165 Class: 4845 NATURE TRAIL ADVANCED AGED RACINE WI 53403 CONNIE OLIVER Gender - Capacity: M/F - 4 (262) 554-6165 CONNIE OLIVER 4845 NATURE TRAIL Low/High rate: 3,000/9,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 08/21/2008 PHYSICALLY DISABLED PUBLIC FUNDING OPEN ARMS 20 LLC (0015801) OPEN ARMS ASSISTED LIVING LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 5335 TAYLOR AVE ADVANCED AGED MT PLEASANT WI 53403 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 456-2459 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 3,500/5,999 ALCOHOL/DRUG DEPENDENT County: RACINE MT PLEASANT WI 53403 Initial License: 10/21/2015 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 25 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

OPEN ARMS 20 LLC (0016257) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 1621 VIRGINIA ST ADVANCED AGED RACINE WI 53403 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 456-4259 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 5,999 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 08/15/2016 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS 20 LLC (0016272) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3725 SHERRIE LN ADVANCED AGED MT PLEASANT WI 53405 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 456-2459 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 5,999 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53403 Initial License: 08/15/2016 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS 20 LLC (0016790) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3824 DAISY LANE ADVANCED AGED MOUNT PLEASANT WI 53403 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 456-2459 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 07/19/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS 20 LLC (0016807) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 519-8588 Class: 9430 JASMINE CT ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 519-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 08/03/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS 20 LLC (0016806) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 519-8588 Class: 3648 91ST PLACE ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 519-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 08/03/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 26 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

OPEN ARMS 20 LLC (0016805) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3708 91ST PLACE ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 519-2588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 08/03/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS 20 LLC GREAT ELMS (0016387) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3519 GREAT ELMS LN ADVANCED AGED RACINE WI 53405 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 456-2459 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 5,999 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 11/10/2016 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS 20 LLC TAYLOR (0016388) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3200 TAYLOR AVE ADVANCED AGED RACINE WI 53405 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 456-2459 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 5,999 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 11/09/2016 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS ASSISTED LIVING (0017153) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3240 WHEELOCK ADVANCED AGED RACINE WI 53405 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,779/8,879 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 06/21/2018 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS ASSISTED LIVING (0017292) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 5422 WESTMORE DR ADVANCED AGED RACINE WI 53406 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 09/24/2018 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 27 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

OPEN ARMS ASSISTED LIVING (0017505) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 9348 ANGELICA DR ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MT PLEASANT WI 53403 Initial License: 03/18/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS ASSISTED LIVING (0017506) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 9008 CHICKORY CREEK DR ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MT PLEASANT WI 53403 Initial License: 03/18/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS ASSISTED LIVING (0017826) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3205 WHEELOCK DRIVE ADVANCED AGED RACINE WI 53403 BASHAR QEDAN Gender - Capacity: M/F - 4 (262) 221-2222 LYNETTE DUKQUITS 6233 BANKERS RD STE 3 Low/High rate: 5,996/6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 02/06/2020 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS ASSISTED LIVING (0017894) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3528 DUCHESS DRIVE ADVANCED AGED RACINE WI 53406 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 5,996/6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 10/30/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY OPEN ARMS ASSISTED LIVING ANGELICA 2 (0017549) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 9311 ANGELICA DR ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 06/06/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 28 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

OPEN ARMS ASSISTED LIVING HAWTHORNE (0017548) OPEN ARMS 20 LLC Type: AFH HCBS COMPLIANT (414) 915-8588 Class: 3653 95TH PLACE ADVANCED AGED STURTEVANT WI 53177 BASHAR QEDAN Gender - Capacity: M/F - 4 (414) 915-8588 LYNETTE DUKQUITS 5335 TAYLOR AVE Low/High rate: 6,975 ALCOHOL/DRUG DEPENDENT County: RACINE MOUNT PLEASANT WI 53403 Initial License: 06/06/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ORCHARD ADULT FAMILY HOME LLC (0016415) ORCHARD ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 880-1873 Class: 2114 ORCHARD ST DEVELOPMENTALLY DISABLED RACINE WI 53405 COURTNEY CONNER Gender - Capacity: M/F - 4 (262) 880-1873 COURTNEY CONNER 2706 Chicory Rd. Low/High rate: 6,000/ EMOTIONALLY DISTURBED/MENTAL County: RACINE Mount Pleasant WI 53405 Initial License: 03/02/2017 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY PARADISE HOUSE (0009180) COMMUNITY CONNECTION LLC Type: AFH HCBS COMPLIANT (414) 906-1915 Class: 3410 STRATFORD AVE DEVELOPMENTALLY DISABLED RACINE WI 53402 Gender - Capacity: M/F - 4 (262) 639-6940 ANGELA ANDERSEN 5225 N IRONWOOD LA STE 116 Low/High rate: 5,735/5,735 PUBLIC FUNDING County: RACINE GLENDALE WI 53217 Initial License: 01/03/2001

PEACEFUL LIVING HOMES LLC (0016953) CHAVOURS JR JOSEPH Type: AFH HCBS COMPLIANT (262) 488-1553 Class: 905 3 MILE RD ADVANCED AGED RACINE WI 53402 JOSEPH CHAVOURS JR Gender - Capacity: M/F - 4 (262) 488-1553 ROBERTA SIMMONS 1718 LASALLE ST Low/High rate: 6,140/7,400 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 07/19/2018 PERSONALLY YOURS ELDER CARE A (0014523) PERSONALLY YOURS ELDER CARE A Type: AFH HCBS COMPLIANT (414) 750-4062 Class: 4525 GUNDERSON ROAD ADVANCED AGED WATERFORD WI 53185 MELINDA DOLPHIN Gender - Capacity: M/F - 4 (262) 895-6666 MELINDA DOLPHIN 4525 GUNDERSON ROAD Low/High rate: 5,500/7,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE WATERFORD WI 53185 Initial License: 03/26/2013 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL PERSONALLY YOURS ELDER CARE B (0012750) PERSONALLY YOURS ELDER CARE B Type: AFH HCBS COMPLIANT (414) 750-4062 Class: 4525 GUNDERSON RD ADVANCED AGED WATERFORD WI 53185 MELINDA J DOLPHIN Gender - Capacity: M/F - 4 (262) 895-6666 MELINDA J DOLPHIN 4525 GUNDERSON ROAD Low/High rate: 5,500/7,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE WATERFORD WI 53185 Initial License: 04/09/2009 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL PERSONALLY YOURS ELDER CARE C (390231) PERSONALLY YOURS ELDER CARE LLC Type: AFH HCBS COMPLIANT (262) 895-6666 Class: 4525 GUNDERSON RD ADVANCED AGED WATERFORD WI 53185 MELINDA DOLPHIN Gender - Capacity: M/F - 4 (262) 895-6666 MELINDA DOLPHIN 4525 GUNDERSON ROAD Low/High rate: 5,000/7,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE WATERFORD WI 53185 Initial License: 09/04/1998 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL

PHOENIX HOUSE (390092) COMMUNITY CONNECTION LLC Type: AFH DEVELOPMENTALLY DISABLED (414) 906-1915 Class: 129 SHEFFIELD DR PUBLIC FUNDING RACINE WI 53402 Gender - Capacity: M - 4 (262) 639-5832 ANGELA ANDERSEN 5225 N IRONWOOD LA STE 116 Low/High rate: 4,560/4,560 County: RACINE GLENDALE WI 53217 Initial License: 05/31/1996

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 29 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

PRICELESS TIME ADULT FAMILY HOME II (0015969) PRICELESS TIME ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 598-4662 Class: 2015 90TH STREET ADVANCED AGED STURTEVANT WI 53177 LUCY BURGESS Gender - Capacity: M/F - 3 (262) 598-4562 LUCY BURGESS PO BOX 085157 Low/High rate: 5,589/17,050 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 03/16/2016 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY PRICELESS TIME ADULT FAMILY HOME IV (0016756) PRICELESS TIME ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 598-4562 Class: 1663 RUSSET STREET ADVANCED AGED RACINE WI 53405 LUCY BURGESS Gender - Capacity: M/F - 4 (262) 598-4562 LUCY BURGESS P O BOX 85157 Low/High rate: 5,000/15,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53406 Initial License: 08/15/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY PRICELESS TIME ADULT FAMILY HOME LLC (0015024) PRICELESS TIME ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 598-4562 Class: 1819 BLAKE AVENUE ADVANCED AGED RACINE WI 53404 LUCY BURGESS Gender - Capacity: M/F - 4 (262) 994-3821 LUCY BURGESS PO BOX 085157 Low/High rate: 4,000/15,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 05/08/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

PRIDE AND JOY ADULT FAMILY GROUP HOME LLC (0016 HUNTING FOR MORE LOVE LLC Type: AFH ADVANCED AGED (262) 880-6019 Class: 2807 DONNA AVE DEVELOPMENTALLY DISABLED RACINE WI 53404 KEYOSHA MOORE Gender - Capacity: M/F - 4 (262) 880-6019 KEYOSHA MOORE 15924 Winston Point Low/High rate: 3,500/5,000 EMOTIONALLY DISTURBED/MENTAL County: RACINE Houston TX 77084 Initial License: 01/05/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PROFESSIONAL CARE GROUP RACINE LLC (0017198) PROFESSIONAL CARE GROUP RACINE LLC Type: AFH HCBS COMPLIANT (414) 617-5848 Class: 3010 16TH STREET ADVANCED AGED RACINE WI 53405 SHIELA ROBERTS Gender - Capacity: F - 4 (414) 617-5848 SHIELA ROBERTS 7107 W FLORIST AVE Low/High rate: 3,000/6,000 DEVELOPMENTALLY DISABLED County: RACINE MILWAUKEE WI 53218 Initial License: 10/05/2018 IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING PROFESSIONAL CARE GROUP RACINE LLC (0017911) PROFESSIONAL CARE GROUP RACINE LLC Type: AFH HCBS COMPLIANT (414) 617-5848 Class: 1708 ARCTURUS AVE ADVANCED AGED RACINE WI 53404 SHIELA ROBERTS Gender - Capacity: M/F - 3 (414) 617-5848 SHIELA ROBERTS 7107 FLORIST AVENUE Low/High rate: 3,000/6,000 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE MILWAUKEE WI 53218 Initial License: 08/25/2020 PHYSICALLY DISABLED TERMINALLY ILL QUALITY CARE ADULT FAMILY HOME II (0016090) QUALITY CARE ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 721-8933 Class: 1508 RUSSET ST DEVELOPMENTALLY DISABLED RACINE WI 53405 KIMBERLY JOHNSON Gender - Capacity: M/F - 3 (262) 456-7447 KIMBERLY JOHNSON 1916 SATURN AVE Low/High rate: 7,000/9,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53404 Initial License: 06/30/2016 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 30 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

QUALITY CARE ADULT FAMILY HOME LLC (0015833) QUALITY CARE ADULT FAMILY HOME LLC Type: AFH HCBS COMPLIANT (262) 721-8933 Class: 1916 SATURN AVE DEVELOPMENTALLY DISABLED RACINE WI 53404 KIMBERLY JOHNSON Gender - Capacity: M/F - 3 (262) 583-4593 KIMBERLY JOHNSON 1916 SATURN AVE Low/High rate: 6,000/9,500 EMOTIONALLY DISTURBED/MENTAL County: RACINE RACINE WI 53404 Initial License: 10/19/2015 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY R JOHNSON HERITAGE HOMES (0013736) HERITAGE HOMES LIVING, LLC Type: AFH HCBS COMPLIANT (262) 939-5000 Class: 1209 NEWMAN RD ADVANCED AGED RACINE WI 53406 RACHEL JOHNSON Gender - Capacity: M/F - 4 (262) 939-5000 RACHEL JOHNSON 1209 NEWMAN RD Low/High rate: 3,049/5,064 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53406 Initial License: 05/13/2011 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TRAUMATIC BRAIN INJURY RAUSCH FAMILY CARE HOME (0012794) SUSAN RAUSCH Type: AFH HCBS COMPLIANT (262) 895-6430 Class: 6831 BIG BEND RD ADVANCED AGED WATERFORD WI 53185 SUSAN RAUSCH Gender - Capacity: M - 3 (262) 895-6430 SUSAN RAUSCH PO BOX 322 Low/High rate: 2,858/3,561 DEVELOPMENTALLY DISABLED County: RACINE WATERFORD WI 53185 Initial License: 04/30/2009 EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING ROOTS RESIDENTIAL ADULT FAMILY HOME LLC (0016563 ROOTS RESIDENTIAL ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 631-3668 Class: 1901 FAIRVIEW TERRACE ALCOHOL/DRUG DEPENDENT RACINE WI 53402 ERICKA GOUDY Gender - Capacity: M/F - 4 (262) 631-3668 JERODD TAYLOR 1100 NORTH MAIN ST Low/High rate: 4,000/7,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53402 Initial License: 05/01/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ROOTS RESIDENTIAL ADULT FAMILY HOME LLC (0016564 ROOTS RESIDENTIAL ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 631-3668 Class: 1936 FRANKLIN ALCOHOL/DRUG DEPENDENT RACINE WI 53403 ERICKA GOUDY Gender - Capacity: M/F - 4 (262) 631-3668 JERODD TAYLOR 1100 NORTH MAIN ST Low/High rate: 4,000/7,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53402 Initial License: 05/01/2017 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC-Lower U ROOTS RESIDENTIAL ADULT FAMILY HOMES LL Type: AFH DEVELOPMENTALLY DISABLED (262) 631-3668 Class: 1715 LASALLE STREET-LOWER EMOTIONALLY DISTURBED/MENTAL RACINE WI 53402 ZEATHA FONDON Gender - Capacity: M/F - 3 (262) 456-4144 ANTWAIN MCINTOSH 1100 NORTH MAIN ST Low/High rate: 4,000/7,000 County: RACINE RACINE WI 53402 Initial License: 08/04/2016 ROOTS RESIDENTIAL ADULT FAMILY HOMES LLC-UPPER ROOTS RESIDENTIAL ADULT FAMILY HOMES LL Type: AFH ADVANCED AGED (262) 631-3668 Class: 1715 LASALLE STREET UPPER ALCOHOL/DRUG DEPENDENT RACINE WI 53402 ERICKA GOUDY Gender - Capacity: M/F - 4 (262) 456-4144 ANTWAIN MCINTOSH 1100 NORTH MAIN ST Low/High rate: 4,000/7,000 CORRECTIONAL CLIENTS County: RACINE RACINE WI 53402 Initial License: 08/04/2016 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 31 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

SAFE HARBOUR HOMES II LLC (0014832) SAFE HARBOUR HOMES, LLC Type: AFH HCBS COMPLIANT (262) 930-6497 Class: 3219 BARBARA DRIVE ADVANCED AGED RACINE WI 53404 WALTER DAVIS Gender - Capacity: M/F - 4 (262) 770-4909 LANA SCHLAGEL 8517 IVANHOE PLACE Low/High rate: 3,875/5,425 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE RACINE WI 53177 Initial License: 12/04/2013 PHYSICALLY DISABLED PUBLIC FUNDING SAFE HARBOUR HOMES III (0015821) SAFE HARBOUR HOMES LLC Type: AFH HCBS COMPLIANT (262) 822-0723 Class: 1103 JACKSON PLACE ADVANCED AGED RACINE WI 53406 WALTER DAVIS Gender - Capacity: - 4 (262) 930-6497 LANA SCHLAGEL 8517 IVANHOE PLACE Low/High rate: 3,875/5,500 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE RACINE WI 53177 Initial License: 11/16/2015 PHYSICALLY DISABLED PUBLIC FUNDING SAFE HARBOUR HOMES IV (0015822) SAFE HARBOUR HOMES LLC Type: AFH HCBS COMPLIANT (262) 822-0723 Class: 1105 JACKSON PLACE ADVANCED AGED RACINE WI 53406 DAVIS WALTER Gender - Capacity: M/F - 4 (262) 930-6497 LANA SCHLAGEL 8517 IVANHOE PLACE Low/High rate: 3,875/5,500 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE RACINE WI 53177 Initial License: 11/16/2015 PHYSICALLY DISABLED PUBLIC FUNDING SAFE HARBOUR HOMES LLC (0014831) SAFE HARBOUR HOMES, LLC Type: AFH HCBS COMPLIANT (262) 930-6497 Class: 5224 16TH STREET ADVANCED AGED RACINE WI 53403 WALTER DAVIS Gender - Capacity: M/F - 4 (262) 770-4909 LANA SCHLAGEL 8517 IVANHOE PLACE Low/High rate: 3,875/5,425 IRREVERSIBLE DEMENTIA/ALZHEIM County: RACINE STURTEVANT WI 53177 Initial License: 12/05/2013 PHYSICALLY DISABLED PUBLIC FUNDING SAFE HARBOUR HOMES LLC (0017766) SAFE HARBOUR HOMES LLC Type: AFH HCBS COMPLIANT (262) 930-8888 Class: 4635 LIMERICK LANE ADVANCED AGED MOUNT PLEASANT WI 53405 WALTER DAVIS Gender - Capacity: M/F - 4 (262) 694-3444 LANA SCHLAGEL 8517 IVANHOE PLACE Low/High rate: 5,200/6,975 DEVELOPMENTALLY DISABLED County: RACINE STURTEVANT WI 53177 Initial License: 08/13/2019 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING SERENITY ON OSBORNE (0015573) RAUSHANAH FRANKLIN Type: AFH HCBS COMPLIANT (404) 414-0237 Class: 3700 OSBORNE BLVD ADVANCED AGED RACINE WI 53405 CHERYL WALKER Gender - Capacity: M/F - 4 (404) 414-0237 CHERYL WALKER 3700 OSBORNE BLVD Low/High rate: 2,500/6,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 05/18/2015 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM SINCERE CARE ADULT FAMILY HOME (0017525) SINCERE CARE ADULT FAMILY HOMES LLC Type: AFH HCBS COMPLIANT (262) 994-9734 Class: 3119 WINDSOR DR ADVANCED AGED RACINE WI 53404 SAHAR ASSAD Gender - Capacity: M/F - 3 (262) 994-9734 SAHAR ASSAD 3611 MONICA DR Low/High rate: 3,000/10,000 ALCOHOL/DRUG DEPENDENT County: RACINE FRANKSVILLE WI 53126 Initial License: 07/12/2019 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY ST REGIS MANOR AFH (0016816) ST REGIS MANOR AFH LLC Type: AFH HCBS COMPLIANT (262) 748-6445 Class: 3507 16TH STREET ADVANCED AGED RACINE WI 53405 DARIUS YOUNG Gender - Capacity: M/F - 4 (262) 583-2288 DARIUS YOUNG 4316 16TH STREET Low/High rate: 7,440/10,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 10/23/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 32 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

TIME TO TREASURE AFH 3 S CORPORATION (0014526) TIME TO TREASURE AFH S CORPORATION Type: AFH HCBS COMPLIANT (262) 880-7036 Class: 2209 PROSPECT STREET ADVANCED AGED RACINE WI 53406 EDNA J YOUNG Gender - Capacity: M - 4 (262) 634-3266 EDNA J YOUNG P O BOX 597 Low/High rate: 5,000/10,000 CORRECTIONAL CLIENTS County: RACINE OAK CREEK WI 53154 Initial License: 02/19/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL TRAUMATIC BRAIN INJURY TIME TO TREASURE AFH 4 S CORPORATION (0014527) TIME TO TREASURE AFH S CORPORATION Type: AFH HCBS COMPLIANT (262) 880-7036 Class: 842 PARK AVENUE ADVANCED AGED RACINE WI 53403 EDNA J YOUNG Gender - Capacity: M/F - 3 (262) 636-0082 EDNA J YOUNG P O BOX 597 Low/High rate: 5,000/10,000 DEVELOPMENTALLY DISABLED County: RACINE OAK CREEK WI 53154 Initial License: 02/19/2013 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TERMINALLY ILL TRAUMATIC BRAIN INJURY TIME TO TREASURE AFH 5 S CORPORATION (0014528) TIME TO TREASURE AFH S CORPORATION Type: AFH HCBS COMPLIANT (262) 880-7036 Class: 5230 BISCAYNE AVE ADVANCED AGED RACINE WI 53406 EDNA J YOUNG Gender - Capacity: F - 3 (262) 554-7425 EDNA J YOUNG P O BOX 597 Low/High rate: 5,000/10,000 CORRECTIONAL CLIENTS County: RACINE OAK CREEK WI 53154 Initial License: 02/19/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TRAUMATIC BRAIN INJURY TIME TO TREASURE AFH 6 S CORPORATION (0014529) TIME TO TREASURE AFH S CORPORATION Type: AFH HCBS COMPLIANT (262) 880-7036 Class: 5232 BISCAYNE AVE ADVANCED AGED RACINE WI 53406 EDNA J YOUNG Gender - Capacity: M - 3 (262) 800-3406 EDNA J YOUNG P O BOX 597 Low/High rate: 5,000/10,000 CORRECTIONAL CLIENTS County: RACINE OAK CREEK WI 53154 Initial License: 02/19/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY TORGERSON ADULT FAMILY HOME (0013658) JILL TORGERSON Type: AFH HCBS COMPLIANT (262) 598-0231 Class: 4381 S PINE RIDGE CR ADVANCED AGED RACINE WI 53403 JILL TORGERSON Gender - Capacity: M/F - 4 (262) 598-0213 JILL TORGERSON 4381 S PINE RIDGE CR Low/High rate: 5,061/5,521 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53403 Initial License: 03/28/2011 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TRAUMATIC BRAIN INJURY TRINITY ADULT FAMILY HOME (0014556) FAITH COMMUNITY ADULT GROUP HOME LLC Type: AFH HCBS COMPLIANT (262) 989-0232 Class: 925 CRAB TREE LANE ADVANCED AGED RACINE WI 53406 DONALD WATSON Gender - Capacity: M/F - 4 (262) 637-4388 DYLAND WEATHER 115 ALGONQUIN ST Low/High rate: 4,582/5,631 ALCOHOL/DRUG DEPENDENT County: RACINE BATTLE CREEK MI 49037 Initial License: 04/18/2013 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL PUBLIC FUNDING TRAUMATIC BRAIN INJURY TRUE LIFE HOMES I (0010761) TRUE LIFE HOMES LLC Type: AFH HCBS COMPLIANT (262) 456-0880 Class: 5532 BYRD AVE ADVANCED AGED RACINE WI 53406 MARIA RODRIGUEZ Gender - Capacity: M - 4 (262) 634-7320 MARIA RODRIGUEZ 2035 LATHROP AVE Low/High rate: 2,500/4,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 12/21/2004 PUBLIC FUNDING TRAUMATIC BRAIN INJURY

TRUE LIFE HOMES II (0011524) TRUE LIFE HOMES LLC Type: AFH HCBS COMPLIANT (262) 456-0880 Class: 920 SOUTH ST DEVELOPMENTALLY DISABLED RACINE WI 53402 MARIA RODRIGUEZ Gender - Capacity: M/F - 4 (262) 456-4191 MARIA RODRIGUEZ 2035 LATHROP AVE Low/High rate: 6,000/24,000 PHYSICALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 10/18/2006 TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 33 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

TRUE LIFE HOMES III (0012374) TRUE LIFE HOMES LLC Type: AFH HCBS COMPLIANT (262) 456-0880 Class: 2620 JEAN AVE DEVELOPMENTALLY DISABLED RACINE WI 53404 DANIEL RODRIGUEZ Gender - Capacity: M/F - 4 (262) 456-2173 DANIEL/MARIA RODRIGUEZ 2035 LATHROP AVE Low/High rate: 3,000/8,000 PHYSICALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 06/12/2008 TRAUMATIC BRAIN INJURY TRUE LIFE HOMES LLC (0012442) TRUE LIFE HOMES LLC Type: AFH HCBS COMPLIANT (262) 456-2173 Class: 621 THUNDERBIRD DR DEVELOPMENTALLY DISABLED RACINE WI 53402 DAN/MARIA RODRIGUEZ Gender - Capacity: M/F - 4 (262) 456-0880 DAN/MARIA RODRIGUEZ 2035 LATHROP AVE Low/High rate: 5,000/6,100 TRAUMATIC BRAIN INJURY County: RACINE RACINE WI 53405 Initial License: 09/25/2008 TRUE LIFE HOMES LLC V (0013227) TRUE LIFE HOMES LLC Type: AFH HCBS COMPLIANT (262) 456-0880 Class: 2428 JEAN AVE ADVANCED AGED RACINE WI 53404 MARIA D RODRIGUEZ Gender - Capacity: M/F - 4 (262) 456-0880 MARIA D RODRIGUEZ 2035 LATHROP AVE Low/High rate: 6,000/24,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 05/06/2010 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM TRAUMATIC BRAIN INJURY VISIONS OF LIFE LLC (0012076) VISIONS OF LIFE LLC Type: AFH HCBS COMPLIANT (262) 898-1201 Class: 7925 DANIEL CT ADVANCED AGED RACINE WI 53406 SHALANDA BEDFORD Gender - Capacity: M/F - 4 (262) 554-0142 SHALANDA BEDFORD PO BOX 085782 Low/High rate: 2,500/5,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408-5782 Initial License: 09/06/2007 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY VISIONS OF LIFE LLC II (0013258) VISIONS OF LIFE LLC Type: AFH HCBS COMPLIANT (262) 898-1216 Class: 3857 LAKEVIEW DR ADVANCED AGED RACINE WI 53403 SHALANDA BEDFORD Gender - Capacity: M/F - 4 (262) 554-0142 MARNICKA MCMILLIAM P O BOX 085782 Low/High rate: 3,000/5,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408-5782 Initial License: 05/27/2010 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY VISIONS OF LIFE LLC III (0014876) VISIONS OF LIFE, LLC Type: AFH HCBS COMPLIANT (262) 554-9566 Class: 3509 S GREEN BAY ROAD ADVANCED AGED RACINE WI 53406 SHALANDA BEDFORD Gender - Capacity: M/F - 4 (262) 554-9566 SHALANDA BEDFORD PO BOX 085782 Low/High rate: 3,000/6,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 12/10/2013 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 34 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

VISIONS OF LIFE LLC IV (0014770) VISIONS OF LIFE LLC Type: AFH HCBS COMPLIANT (262) 554-9566 Class: 6545 LINCOLNSHIRE DR ADVANCED AGED RACINE WI 53403 SHALANDA BEDFORD Gender - Capacity: M/F - 4 (262) 552-2955 SHALANDA BEDFORD PO BOX 085782 Low/High rate: 3,000/6,000 ALCOHOL/DRUG DEPENDENT County: RACINE RACINE WI 53408 Initial License: 10/03/2013 CORRECTIONAL CLIENTS DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY VISTA VILLAGE LIVING CENTER II (0016602) VISTA VILLAGE LIVING CENTER LLC Type: AFH ADVANCED AGED (262) 210-6960 Class: 2820 INDIANA STREET ALCOHOL/DRUG DEPENDENT RACINE WI 53405 DAROLD BEECHUM Gender - Capacity: M/F - 4 (262) 721-6653 ALICIA MORRIS 1900 LATHROP Low/High rate: 3,500/15,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53405 Initial License: 04/17/2017 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY VISTA VILLAGE LIVING CENTER LLC (0014302) VISTA VILLAGE LIVING CENTER LLC Type: AFH HCBS COMPLIANT (262) 210-6960 Class: 2040 FRANKLIN ST ADVANCED AGED RACINE WI 53403 Darold Beechum Gender - Capacity: M/F - 4 (262) 833-5027 DAROLD BEECHUM 1900 Lathrop Low/High rate: 3,500/15,000 ALCOHOL/DRUG DEPENDENT County: RACINE Racine WI 53405 Initial License: 10/15/2012 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

VISTA VILLAGE LIVING CENTER V (0017291) VISTA VILLAGE LIVING CENTER LLC Type: AFH ADVANCED AGED (262) 210-6960 Class: 2047 INDIANA ST ALCOHOL/DRUG DEPENDENT RACINE WI 53403 Darold Beechum Gender - Capacity: M/F - 4 (262) 770-4007 DAROLD BEECHUM 1900 Lathrop Low/High rate: 4,000/12,000 DEVELOPMENTALLY DISABLED County: RACINE Racine WI 53405 Initial License: 01/24/2019 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY WILLIAMS COMPASSIONATE CARE MANOR LLC (0014871 WILLIAMS COMPASSIONATE CARE MANOR, LLC Type: AFH HCBS COMPLIANT (262) 456-7873 Class: 601 SYDNEY DRIVE ADVANCED AGED RACINE WI 53402 ROBERT G. WILLIAMS Gender - Capacity: M/F - 4 (262) 456-7873 PERE A. EPPS 601 SYDNEY DRIVE Low/High rate: 4,500/8,000 DEVELOPMENTALLY DISABLED County: RACINE RACINE WI 53402 Initial License: 09/04/2014 EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PUBLIC FUNDING TERMINALLY ILL

*The Adult Family Home (AFH) directory is updated monthly. Wisconsin Department Division of Quality Assurance Directory 08/31/2021 of Health Services UdtdPage 35 Public Directory By Facility Name For Facility Type AFH Racine

Facility Name and Address Licensee Name and Phone Phone Number / Contact Person Mailing Address Specialty Programs

WILLOW RUN 3 (0013991) WILLOW RUN FAMILY GROUP HOME INC Type: AFH HCBS COMPLIANT (262) 806-7252 Class: 316 GARFIELD ST ADVANCED AGED BURLINGTON WI 53105 THOR CHRISTIANSEN Gender - Capacity: M/F - 4 (262) 806-7252 ELIZABETH BALL 104 CLARK ST Low/High rate: 3,920/4,340 ALCOHOL/DRUG DEPENDENT County: RACINE BURLINGTON WI 53105 Initial License: 01/25/2012 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY

WILLOW RUN ADULT FAMILY GROUP HOME (390235) WILLOW RUN ADULT FAMILY GROUP HOME INC Type: AFH HCBS COMPLIANT (262) 806-7252 Class: 104 CLARK ST DEVELOPMENTALLY DISABLED BURLINGTON WI 53105 THOR CHRISTIANSEN Gender - Capacity: M/F - 4 (262) 806-7252 ELIZABETH BALL 104 CLARK ST Low/High rate: 2,865/3,172 EMOTIONALLY DISTURBED/MENTAL County: RACINE BURLINGTON WI 53105 Initial License: 11/01/1998

WIND POINT VILLA ADULT FAMILY HOME (0014859) NICOLE PFEIFER Type: AFH HCBS COMPLIANT (414) 554-8280 Class: 314 JONSUE LANE ADVANCED AGED WIND POINT WI 53402 NICOLE PFEIFER Gender - Capacity: M/F - 4 (414) 554-8280 NICOLE PFEIFER 314 JONSUE LANE Low/High rate: 130/400 DEVELOPMENTALLY DISABLED County: RACINE WIND POINT WI 53402 Initial License: 02/04/2014 PHYSICALLY DISABLED PUBLIC FUNDING TRAUMATIC BRAIN INJURY WISCONSIN LIVING LLC (THE) (0017604) THE WISCONSIN LIVING LLC Type: AFH HCBS COMPLIANT (262) 391-2706 Class: 3336 10TH AVE ADVANCED AGED RACINE WI 53402 SUREN SIVANANTHAN Gender - Capacity: M/F - 4 (262) 391-2706 SUREN SIVANANTHAN 18120 PRAIRIE FALCON LN Low/High rate: 4,000/8,500 ALCOHOL/DRUG DEPENDENT County: RACINE BROOKFIELD WI 53045 Initial License: 07/01/2019 DEVELOPMENTALLY DISABLED EMOTIONALLY DISTURBED/MENTAL IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED TERMINALLY ILL TRAUMATIC BRAIN INJURY WOOD ADULT FAMILY HOME LLC (0016414) WOOD ADULT FAMILY HOME LLC Type: AFH ADVANCED AGED (262) 880-1873 Class: 4406 WOOD RD DEVELOPMENTALLY DISABLED MOUNT PLEASANT WI 53403 COURTNEY CONNER Gender - Capacity: M/F - 4 (262) 880-1873 COURTNEY CONNER 2706 CHICORY RD Low/High rate: 6,000/ EMOTIONALLY DISTURBED/MENTAL County: RACINE MT PLEASANT WI 53403 Initial License: 01/10/2017 IRREVERSIBLE DEMENTIA/ALZHEIM PHYSICALLY DISABLED PUBLIC FUNDING TERMINALLY ILL TRAUMATIC BRAIN INJURY

*The Adult Family Home (AFH) directory is updated monthly.