Daily life in a Colorado assisted living home
Last reviewed: August 27, 2026
This page is for adult children on Colorado’s Western Slope who want to know what a licensed assisted living home is actually supposed to provide every day. It is educational only. It is not medical advice, legal advice, or a recommendation of any home.
This directory is a separate business from High Desert Assisted Living in Clifton, Colorado. Jason and Laura Cheney operate both; the directory is not an official state list and is not a CDPHE, HCPF, or Medicare rating tool. Nothing on this page is a recommendation of that home. This page does not describe that home’s meals, medication pass, staffing, or activity calendar.
Colorado’s current assisted-living rule is 6 CCR 1011-1 Chapter 7 (Board of Health adopted January 15, 2025; effective March 17, 2025). Medication-administration details also come from Chapter 24 and CDPHE’s QMAP page. This is not a quote of any home’s daily schedule.
The short version
A Colorado Assisted Living Residence is licensed for 24-hour supervision, not 24-hour nursing. Chapter 7 says the license is for people who need regular supervision “but not to the extent that regular twenty-four hour medical or nursing care is required.”
Every day the home must make available a safe, clean setting; room and board; help with daily tasks; someone watching out for the person; and a chance to stay socially engaged. It does not guarantee a statewide staff-to-resident ratio, a nurse on every shift, or a particular menu.
Meals: at least three a day, at regular times (or per the care plan); snacks and substitutes; drinks including water all day; weekly menus posted at least 24 hours ahead.
Medications: most homes use QMAPs (unlicensed staff who completed a state-approved course), plus a nurse or CNA-Med if they have one. The resident must be able to consent and participate. A QMAP is not a nurse.
Staffing: ask for this home’s written disclosure — its own minimum staffing, whether staff are awake 24 hours, and how much licensed or certified clinical staff is on site. There is no statewide private-pay ratio.
Night safety check: at least one check of all consenting residents between 10 p.m. and 6 a.m.
Activities: required resident engagement, not a bingo mandate.
Visitors: the resident has the right to have visitors at any time. House rules cannot take that away.
On a tour, take home the written list of what is in the rate vs every optional service with a price, and the staffing disclosure. Ask whether extra bathing, 1:1 activity, or a special diet is an add-on. This page does not invent prices.
24-hour supervision, not 24-hour nursing
An Assisted Living Residence makes available, to three or more adults not related to the owner: room and board; personal services; protective oversight; social care; and regular supervision on a 24-hour basis — not regular 24-hour medical or nursing care (Chapter 7, 2.7). CDPHE’s Assisted Living Residences page reprints that definition.
What the home must make available every day (12.1):
- a physically safe and sanitary environment
- room and board
- personal services (help with daily life, plus a way for staff to notice and escalate a problem)
- protective oversight (someone paying attention, and acting when something unexpected happens)
- social care and resident engagement
Some of this can be arranged rather than staffed in-house. It still has to be available and enough to meet needs.
Personal services include a safe setting, individualized social supervision, help with transportation, and help with activities of daily living — eating, dressing, grooming, bathing, mobility, using the toilet, and the rest of the 2.3 list. How much bathing help, how often, and whether extra showers are in the rate or extra is an 11.6 question. Chapter 7 does not set a bath-per-week minimum. There isn’t one.
Protective oversight means being aware of a resident’s general whereabouts (the person may still travel independently in the community) and monitoring activities on the premises. That is not 24-hour nursing. It is also not a locked unit unless the home operates a secure environment and has disclosed that.
A nurse may provide nursing services to support personal services. Those services must not rise to regular 24-hour medical or nursing care (12.2). Occasional tube feeding, IV medication, certain catheter or ostomy care, and care for a stable stage 1 or 2 pressure sore may be done only by a nurse or an outside provider (12.3). A person who needs regular 24-hour medical or nursing care is not an assisted-living admission (11.2(A)). If care later rises to that level, Chapter 7 says this is the wrong license.
Home health or hospice can come in. That does not turn the building into a nursing home.
An Alternative Care Facility (ACF) is the same assisted-living license plus a Medicaid payer certification. It is not a second CDPHE daily-life license. This page does not import ACF staffing numbers.
Meals
Part 17 is specific about how many meals, drinks, snacks, posted menus, and dining-room access. It is thin on what is on the plate. This page does not invent sample menus.
What the rule requires
- At least three meals daily, at regular times comparable to normal community mealtimes, or per the resident’s needs, preferences, and care plan (17.1).
- Nourishing substitutes and between-meal snacks for people who want to eat at non-traditional times (17.1(A)).
- A variety of foods, nutritionally balanced, and enough to satisfy appetite. Appealing substitutes of similar nutritive value if the person declines what was first served (17.2).
- Drinks, including water, with every meal and between meals. Residents shall have independent access to drinks at all times (17.3).
- Staff watch food consumption for unplanned weight change or dehydration (17.4).
- Menus vary daily and can include seasonal or holiday foods (17.6).
- Weekly menus posted for residents and the public no less than 24 hours before serving (17.7).
- Residents encouraged to help plan menus; reasonable efforts to accommodate suggestions (17.8).
- Enough food on hand for three nutritionally balanced meals a day for three calendar days (17.9).
A therapeutic diet (calorie-counted, a specific sodium diet, a cardiac diet, and the like) is a diet ordered by a practitioner or registered dietitian. The home may provide one when it is prescribed and staff are trained to prepare it and serve it to the right person (17.10). That is a permission, not a mandate. Whether a diabetic, low-sodium, or texture-modified diet is in the rate or an extra charge is an 11.6 question. Do not assume every home offers every diet.
Staff must promptly help a person who cannot open, reach, or get to food and drink, wherever they are dining (17.11). Cueing is allowed if it is not for staff convenience (17.12). Staff may help with feeding only if the person can stay upright and chew and swallow without difficulty, and only if trained by a qualified professional (17.13–17.14).
There is a designated dining area all residents can use. Residents get to choose where and with whom to sit. Meals are not routinely served in rooms unless the care plan says so (17.15–17.18). Paper plates are not for regular meals except in emergencies and outdoor dining (17.19).
Food safety is not a menu. Homes licensed for 19 or fewer beds do not need a commercial kitchen (16.4). Family-brought food is not banned by Part 16. Cooking is not allowed in sleeping rooms; residents must have access to a place where minimal food preparation is allowed (22.38–22.39).
CDPHE’s 2019 How to Choose checklist still asks families to observe a meal. That is a tour tip, not a state menu, calorie count, or snack-cart schedule.
Medications — QMAP is not a nurse
This is not a nursing-home med pass. Unlicensed QMAPs do most routine handing of pills in many homes. They follow a written order. They do not diagnose, decide a PRN is “needed,” inject, or hide medicine in food.
Who may administer (14.1): a practitioner, a nurse, a QMAP, or a CNA-Med, each acting in scope.
| Role | What that means |
|---|---|
| Practitioner | Physician, PA, or advance-practice nurse who orders the drug. |
| Nurse | Licensed nurse. Can assess, use judgment, and do tasks a QMAP cannot (injections, IV, tube feeding). Not required on every shift. |
| QMAP | Unlicensed staff who completed a state-approved medication class. CDPHE: a QMAP is not certified or licensed and is not trained or authorized to make any judgment, assessment, or evaluation. |
| CNA-Med | A certified nurse aide with extra medication-aide authority. Still not a nurse. |
CDPHE’s QMAP page says QMAP classes teach unlicensed staff to safely administer medications in certain settings. Assisted living residences are the first listed authorized setting. Families can verify a name on CDPHE’s QMAP table. Paper certificates are not official; online verification is.
Chapter 24 requires a qualified medication administration person on site any time medication is administered, including PRN.
The resident must be able to consent and participate (14.3). The home shall not let a QMAP or CNA-Med assist with medication unless the resident can consent and take part in consuming it. If the person cannot, a QMAP med pass is the wrong tool — and the home may not be able to keep the person if it has no licensed or Chapter 24-qualified staff to administer (11.2(B)).
What QMAPs may not do (14.10), unless a statute says otherwise:
- injections (IV, IM, or subcutaneous)
- tube feeding
- chemical debridement
- medication used as restraint
- titrating oxygen
- deciding that a PRN / “as needed” medication is needed
- assessing the resident or judging how a drug is working
- pre-pouring medication
- hiding pills in food or drink
If a family is told “we crush it in applesauce so they don’t know,” that is a 14.10 problem, not a kindness.
PRN limits (14.9): a QMAP may give a PRN only in a licensed mental-health residential treatment facility; or when the resident understands the purpose, can voluntarily ask for it, and a practitioner has documented that this use is appropriate; or where a statute specifically allows it. QMAPs do not decide the person “looks like they need” a pain pill or a sleep aid.
Each resident has the right to refuse medications (14.16). Personal medication is the resident’s property. No one has to surrender the right to possess or self-administer unless a practitioner has determined they lack the capacity to do so safely (14.14).
Regular 24-hour medical or nursing care is still a do-not-admit / discharge line. Occasional injections, insulin, or tube feeding belong to a nurse or an outside provider, not a QMAP.
Staffing is this home’s written disclosure, not a statewide ratio
A full-text search of today’s Chapter 7 PDF found no staff-to-resident ratio. Do not accept “we meet state ratios.” Chapter 7 has none for private-pay assisted living. This page does not invent a Colorado ratio.
What the rule does instead:
- The home sets routine staffing after considering resident acuity, the care plan, and the resident agreement (8.3).
- Staff “shall be sufficient in number to help residents needing or potentially needing assistance” (8.4).
- The home must tell the new resident its own minimum staffing levels, whether staff are awake 24 hours, and how much licensed or certified clinical staff is on site (11.7(C)).
- Volunteers and resident helpers do not count toward staffing (8.12).
11.7(C) is the staffing hook. Ask for it in writing. “Awake 24 hours” is a disclosure, not a mandate for every home. A home may legally operate without awake-all-night staff if it discloses that — except in a secure environment (marketed memory care that limits free exit), which does require one trained, awake staff member on duty in that unit at all times (25.18). That awake-staff rule is for the secure unit, not a statewide night-staffing mandate. It is still not a staff-to-resident ratio.
What the rule requires for presence
- Whenever a resident is in the building: at least one staff member present who is capable of responding to an emergency (8.1 / 8.7).
- At least one staff member on site at all times with current Adult First Aid (8.6).
- At least one staff member on site at all times with current Adult CPR and obstructed-airway certification that included a skills check (8.7).
- A visible, up-to-date list of who is certified (8.8).
- The administrator or a qualified designee is always reachable. Name and contact information shall always be readily available to residents and the public (6.8). When a designee is covering in a home licensed for more than 12 beds, there shall be at least one other staff member on duty whose primary job is daily care. That is a second-body rule for that situation, not a statewide ratio.
Direct-care staff who regularly work with residents living with dementia must complete at least four hours of dementia training (and two hours every two years after that). That applies to all assisted living homes, not only “memory care” (7.9(B)). A home that operates a secure environment has extra Part 25 training and disclosure on top of that.
Night safety check (10 p.m. to 6 a.m.)
Between 10 p.m. and 6 a.m., staff shall conduct at least one safety check of all consenting residents (8.2).
Ask: do you do that check? Of consenting residents only? Who is in the building overnight, and are they awake?
Activities — required engagement, not a bingo mandate
The home must make social care and resident engagement available (12.1(E)). That means:
- encourage residents to keep and develop independent living through individual and group opportunities (12.19)
- give all residents regular chances at structured engagement, and support each person’s own interests (12.20)
- if asked, help the person find outside services and community events (12.21)
- post notices of planned offerings in a central place; keep copies at least six months (12.26)
- evaluate the engagement program at least every three months (12.24)
- whenever feasible, help with community events and attendance at the place of worship of the resident’s choice (12.25)
Chapter 7 lists examples — conversation, crafts, music, pet care, exercise, classes, community events, worship. Those are examples, not a required activity grid. The rule does not require bingo, a published weekly calendar of specific games, or guaranteed 1:1 activity time. If they sell 1:1 activity as an extra, it belongs on the 11.6 optional list with a charge.
Who is responsible for engagement depends on licensed capacity, and that is still not a staff-to-resident ratio:
- 19 or fewer beds: the administrator is primarily responsible (a waiver is possible if residents are self-directed enough to run it). Do not expect a full-time activities director in a small house. Ask how engagement actually happens.
- 20 to 49 beds: the administrator designates one staff member. The rule does not say “full time.”
- 50 or more beds: at least one staff member whose sole responsibility is engagement.
There must be a comfortable living-room-type space and an outdoor area residents can actually get to (12.31).
The care plan is supposed to name formal and informal engagement that matches this person’s interests (12.10(F)). Ask how they support those interests — not for a generic calendar this page will not invent.
Visitors at any time
Residents have “the right to have visitors at any time” (13.1(A)). They also have private and unrestricted communications, private phone or electronic communication, and unopened mail.
House rules must address visitors (13.4). House rules shall not supersede Chapter 7 or hinder a resident’s rights. A house rule that quietly bans evening visitors undercuts 13.1.
Other daily-life rights on the same list: clothing of choice unless the care plan says otherwise; the right to exercise choice in attending religious activities; the right to participate in activities outside the home and request help with transportation; full use of common areas under written house rules; quarterly resident and family meetings, including the right to meet without staff present (13.5–13.9).
Ombudsmen have access during regular business or visiting hours and whenever an investigation requires it (13.2).
What to ask (no prices)
Take the 11.6 list (included services vs every optional service with a specified charge) and the 11.7(C) staffing disclosure home. Amendments must be signed (11.5). Service or charge changes generally need 30 days’ written notice.
Daily help
- What personal services are in the monthly rate — bathing (how often), dressing, toileting, transfers, walking, getting to activities? Extra bathing can be an add-on if it is on the optional list. There is no statewide bath-per-week minimum.
- Is 1:1 activity or extra outing staff optional?
- Is a therapeutic or special diet included or extra? Who prepares it, and what training do they have?
- What do you not provide, and what will you help us arrange from outside?
Staffing and nights
- What are your minimum staffing levels (the number you disclose — not a state ratio)?
- Are staff awake 24 hours? If not, who is in the building overnight?
- How much licensed or certified clinical staff is on site, and when? Is there a nurse, and on which shifts?
- Do you do the 10 p.m.–6 a.m. safety check of consenting residents?
- Who on this shift is current in Adult First Aid and Adult CPR? Where is the posted list?
- If they market memory care: one trained awake staff member in that unit at all times? Extra dementia training?
Medications
- Who hands medications — QMAP, CNA-Med, or nurse?
- May I verify the QMAP names on CDPHE’s online table?
- How do you handle consent and participation if the person is confused?
- How do PRNs work? Does the resident have to ask?
- Do you ever conceal medication in food or drink? (They must not, for a QMAP.)
- Can the person keep and self-administer their own meds? What would change that?
Meals and activities (on the tour)
- Observe a meal if they will let you. Watch help at the table, substitutes, and whether anyone is excluded from the dining room.
- Where is this week’s menu posted? Was it up 24 hours ahead?
- Snacks and drinks between meals — where, and can the person get water without asking?
- Show me the posted engagement notices. May I see copies from the last six months?
- Who is responsible for engagement given your licensed capacity?
- Visitors at any time? Any house rule that actually limits that?
Tour more than once. Make one visit unannounced, or stay for a meal. Take the packet home. Do not sign on tour day.
Look the license up yourself on CDPHE Find and Compare.
If something is going wrong, the state long-term care ombudsman is 303-862-3524 (CDHS; checked on CDPHE’s consumer-resources page August 27, 2026). They do not license or fine homes. Local Mesa / Region 11 numbers live on this directory’s help-map page; this brief did not re-dial them.
Official pages this guide used
- 6 CCR 1011-1 Chapter 7
- 6 CCR 1011-1 Chapter 24 (medication administration)
- CDPHE Assisted Living Residences
- CDPHE QMAP / medication administration
- CDPHE Assisted Living Residence Consumer Resources
- CDPHE Find and Compare Facilities
This page does not invent staff-to-resident ratios, sample daily calendars, or a bath-per-week minimum. It is not a quote of any home’s operations and not a recommendation.