Minnesota : DHS		  
 
      
 


License Details

Basic license details.
Fourth Avenue Homes License status: Active
328 5TH ST SW STE 5
Willmar, MN 56201
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(320) 231-2738
Kandiyohi County

License number: 1068742
License holder: Fourth Avenue Homes Inc
License Holder Entity Identification Number(s): 3839884
License status: Active
Type of service: Home and Community Based Services
Initial effective date: January 1, 2014
Last renewed or updated on: January 1, 2024
Next renewal due: December 31, 2024


Licensed to provide

Basic Support Services:
Adult companion services
Homemaker
Personal support
Respite care, in home or out-of-home
Individual community living support
Individualized home supports

Intervention Support Services:
Positive supports
Specialist services
Crisis respite, in-home or out-of-home

In-Home Support Services:
In-home family support
Independent living skills training
Semi-independent living skills
Individualized home supports
Individualized home supports with training
Individualized home supports with family training

Residential Supports and Services:
Foster Care services or supported living services
Supported living services in a SLF
Community residential services
Family residential services

Restrictions: None

Satellite Locations

Satellite License Number: 1068743 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes
184 Lakeview Dr
Spicer, MN 56288

Satellite License Number: 1068744 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes
141 4th Ave W
Spicer, MN 56288

Satellite License Number: 1068745 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes
140 W 4th Ave
Spicer, MN 56288

Satellite License Number: 1068746 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
180 Lakeview Dr
Spicer, MN 56288

Satellite License Number: 1068747 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
1306 15TH ST SW
Willmar, MN 56201

Satellite License Number: 1068748 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes
117 2nd St SE
Pennock, MN 56279

Satellite License Number: 1068749 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
200 Maverick Dr
Mankato, MN 56001

Satellite License Number: 1068750 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
5015 130th Ave Attn: Swanson Jack
Kerkhoven, MN 56252

Satellite License Number: 1068751 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes
2212 22nd St SW
Willmar, MN 56201

Satellite License Number: 1068752 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
500 19th St
Benson, MN 56215

Satellite License Number: 1068754 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
181 LAKEVIEW DR
Spicer, MN 56288

Satellite License Number: 1076665 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
3065 90TH AVE SE
Clara City, MN 56222

Satellite License Number: 1077981 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
925 15TH ST SW
Willmar, MN 56201

Satellite License Number: 1078392 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
1428 Highland Dr
Winona, MN 55987

Satellite License Number: 1079135 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
2409 7TH AVE SE
Willmar, MN 56201

Satellite License Number: 1082304 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
735 JUDSON FORT RD E
Lake Crystal, MN 56055

Satellite License Number: 1082473 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
3870 WINESAP DR NW
Rochester, MN 55901

Satellite License Number: 1084575 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
804 S FRANKLIN ST
New Ulm, MN 56073

Satellite License Number: 1085127 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
406 7th St N
Kerkhoven, MN 56252

Satellite License Number: 1091926 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
22531 COUNTY ROAD 13
New Ulm, MN 56073

Satellite License Number: 1096016 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes
21241 600TH AVE
Litchfield, MN 55355

Satellite License Number: 1098081 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
3767 MCINTOSH DR NW
Rochester, MN 55901

Satellite License Number: 1100577 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
1902 122ND AVE NE
Spicer, MN 56288

Satellite License Number: 1102757 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Crestview
625 CRESTVIEW LN
Owatonna, MN 55060

Satellite License Number: 1103014 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Lloyd House
5873 LLOYD ST NW
Rochester, MN 55901

Satellite License Number: 1103015 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
2451 MEADOW HILLS DR SW
Rochester, MN 55902

Satellite License Number: 1104516 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
313 COLE CT
Mankato, MN 56001

Satellite License Number: 1105658 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc Goodview
4240 W 7TH ST
Winona, MN 55987

Satellite License Number: 1105958 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
2296 NORTHRIDGE DR
North Mankato, MN 56003

Satellite License Number: 1105981 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
1950 DIABLO DR SE
Owatonna, MN 55060

Satellite License Number: 1107671 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
2100 198TH ST W
Faribault, MN 55021

Satellite License Number: 1107834 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
2803 OAKRIDGE DR SW
Rochester, MN 55902

Satellite License Number: 1113333 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes River Court
134 N RIVER CT NE
Rochester, MN 55906

Satellite License Number: 1113952 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
523 43RD AVE NW
Rochester, MN 55901

Satellite License Number: 1114728 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
5375 RIDGEWAY RD NW
Rochester, MN 55901

Satellite License Number: 1114742 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc
108 CHAUCER CT
Mankato, MN 56001

Satellite License Number: 1115232 (Home and Community Based Services - Community Residential Setting)
Fourth Ave Homes Inc
3413 9TH AVE NW
Rochester, MN 55901

Satellite License Number: 1115695 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes Inc 53rd Avenue
740 53RD AVE
Winona, MN 55987

Satellite License Number: 1117539 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
1900 GREENWOOD DR
Owatonna, MN 55060

Satellite License Number: 1120025 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
317 VOS PARK DR
Willmar, MN 56201

Satellite License Number: 1120872 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
1380 MARIGOLD CIR
Victoria, MN 55386

Satellite License Number: 1123153 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
120 TORREY PINES CT
Mankato, MN 56001

Satellite License Number: 1123520 (Home and Community Based Services - Community Residential Setting)
Fourth Avenue Homes
6275 BROADWAY AVE N
Rochester, MN 55906

Additional information
Certification: Adult Mental Health Certification - Community Residential Setting - Site Specific
Note: For additional information relating to providers who are licensed by an authority other than the Minnesota Department of Human Services, please contact the licensing authority directly. A directory of county agencies is online.

Public documents available for this license.
Licensing Actions and Maltreatment Investigation Memorandums
Documents below appear for four years from the date of posting
Document type Date issued Format
Correction Order 1/17/2024 HTML
Maltreatment Investigative Memorandum 1/17/2024 HTML
Maltreatment Investigative Memorandum 10/27/2023 HTML
Maltreatment Investigative Memorandum 7/14/2023 HTML
Maltreatment Investigative Memorandum 6/23/2023 HTML
Maltreatment Investigative Memorandum 3/29/2023 HTML
Correction Order 2/3/2023 HTML
Maltreatment Investigative Memorandum 2/3/2023 HTML
Maltreatment Investigative Memorandum 8/3/2022 HTML
Maltreatment Investigative Memorandum 11/19/2021 HTML
Maltreatment Investigative Memorandum 5/21/2021 HTML
Maltreatment Determination and Fine Order 2/19/2021 HTML
Maltreatment Investigative Memorandum 2/19/2021 HTML
Maltreatment Investigative Memorandum 1/20/2021 HTML
Maltreatment Investigative Memorandum 11/13/2020 HTML
Maltreatment Investigative Memorandum 10/2/2020 HTML
Maltreatment Investigative Memorandum 7/10/2020 HTML


Human Services (DHS) licensing web page statement:

The information found on this web page is public information. Types of public information you will find on this website include:

  • Maltreatment investigation memorandum*
  • Licensing actions for license types other than family child foster care, including: conditional licenses, fines, revocations, indefinite suspensions, and temporary immediate suspensions (See the glossary of terms for an explanation of each type of licensing action.) Please note that licensing actions for family child foster care are public documents and available upon request from DHS.
  • Summary of reviews and investigations for family child care**
  • Decisions issued by DHS to appeals of violations cited on correction orders and conditional licenses
  • Final agency decisions for licensing actions
  • Correction Orders for license types other than family child care, child foster care, adult foster care, and family adult day service programs. Please note that correction orders are public documents and available upon request from DHS, the licensing county, or the licensing agency

*Maltreatment allegations involving a family child care or family child foster care program are conducted by the County in which the alleged incident occurred.

**Summary of reviews and investigations for all other provider types will be added in the future.

Determinations may be subject to appeal. Not all records related to the license are included on this web page. If you view information that you believe is not public, notify DHS Licensing Division immediately by calling (651) 431-6500.

Minnesota Department of Human Services website accessibility disclaimer: The Minnesota Department of Human Services has a policy of making the information on its websites accessible to people with disabilities. Pursuant to this commitment, DHS implements the provisions of the Americans with Disabilities Act and the Minnesota Human Rights Act. If you experience any difficulty accessing the content, call (651) 431-6500 or send an electronic mail message to DHS.LicensingDivision@state.mn.us to receive the subject matter in an alternative format. Indicate the nature of your accessibility problem, your preferred format, the license number of the facility, type and date of the document and your contact information so DHS can reach you with any questions in fulfilling your request.