Small house vs large campus
Last reviewed: August 27, 2026
This page is for adult children on Colorado’s Western Slope who are trying to choose between a house-sized assisted living home and a larger community. It is educational only. It is not a ranking, a quote, 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 staffing, kitchen, baths, or rates.
Colorado uses the same Assisted Living Residence license either way. “Small house” is not a Colorado license type. Neither size is better. There is no invented cost difference — CareScout’s 2025 survey mixes both into one median. The official Mesa list has no capacity field, so this page does not invent a small-vs-campus count.
The short version
A house driveway and a larger campus are shopping the same license. Chapter 7 (6 CCR 1011-1 Chapter 7, adopted January 15, 2025; effective March 17, 2025) licenses one Assisted Living Residence: three or more adults not related to the owner, with room and board, personal services, protective oversight, social care, and 24-hour supervision — not regular 24-hour nursing.
What does not change with size: administrator qualifications, the written resident agreement, QMAP medication rules, involuntary-discharge rules, and the Find and Compare listing.
What does change with licensed capacity is a short list of daily-life thresholds: who is responsible for resident engagement; retail-food rules at 20 or more beds; one extra daily-care staff member when a designee runs a home over 12 beds; and one full bathroom per six residents. Those are thresholds, not a winner.
Ask this building: who cooks, who is in charge at night, whether baths are shared, what happens when someone calls out, and whether a nurse is on site. Get the written fee sheet.
Same license either way
Colorado does not license a “small house” and a “campus” as two different things. A full-text search of today’s Chapter 7 found no “small house,” “small home,” “campus,” or “mom-and-pop” license class. A 3-bed home and a 100-bed home are both ALRs if they meet the 2.7 definition.
A smaller building is not “better.” A larger building is not “more professional.” This page does not rank them.
Memory care / a secure environment can exist in a small house or on a campus. Part 25 is optional, not size-based.
What does not change
| Topic | The same in any Colorado ALR |
|---|---|
| License | One Assisted Living Residence license. |
| Administrator | Same qualifications at every size (at least 21, high-school diploma or equivalent, and the experience or license substitutes in 6.3; 40-hour administrator training). Every home must have an administrator plus a qualified designee who can fill in. Name and contact of whoever is on duty must always be readily available. The owner is not required to live on site. |
| Resident agreement | Written, signed, and dated at move-in. Charges, refunds, deposits; what is and is not provided; services in the rate and every optional service with a price; hold-a-place fee; who provides linens and furnishings; discharge reasons. Cannot waive the rules. |
| QMAP / medications | Same Part 14 and Chapter 24 rules. A QMAP is not a nurse. The resident must be able to consent and participate. Limits (no injections, no hiding pills, no PRN decision-making) do not change with bed count. |
| Discharge | Same 30-calendar-day written notice and grievance path. |
| Find and Compare | Every currently licensed ALR appears there. Surveys and occurrence reports are the official public file. |
| Daily services | Safe setting, room and board, personal services, protective oversight, social care and engagement — enough to meet residents’ needs. |
| Nursing ceiling | A nurse may support personal services. Regular 24-hour medical or nursing care is the wrong license. |
| Staff on site | Whenever residents are present: someone who can handle an emergency, plus first aid and CPR coverage on site. A night safety check of consenting residents between 10 p.m. and 6 a.m. Staff “sufficient in number.” No statewide private-pay staff-to-resident ratio. Volunteers do not count. |
| Cannot exceed the license | The home shall not care for more residents than the beds it is licensed for. |
Ask for the same papers in every building: the 11.6 fee sheet, the 11.7 staffing / sprinkler / secure-environment disclosure, and the latest survey.
What changes by licensed capacity
These are thresholds, not a quality ranking.
More than 12 beds — extra coverage when a designee is in charge. When a qualified designee is acting as administrator, there shall be at least one other staff member on duty whose primary job is daily resident care (6.8(L)(3)). That is not a staff-to-resident ratio. Homes licensed for 12 or fewer beds do not get that extra sentence; they still must have emergency-capable staff, first aid, and CPR on site.
Engagement staff
- 19 or fewer residents: the administrator is primarily responsible for organizing engagement. A waiver is possible if residents are self-directed enough to run it. That does not mean “no activities.” Every ALR still owes social care and resident engagement.
- 20 to 49 residents: the administrator shall designate one staff member to organize engagement. Designated is not the same as “sole duty.”
- 50 or more residents: at least one staff member whose sole responsibility is engagement.
Kitchen
- Fewer than 20 beds: “A commercial kitchen is not a requirement.” Staff who prepare or serve food still need recognized food-safety training. Three meals, snacks, and posted menus still apply.
- 20 or more beds: the home shall also comply with Colorado Retail Food Establishment rules (6 CCR 1010-2). This page does not restate that chapter’s equipment list.
Baths — every ALR, any size. At least one full bathroom for every six residents. A full bathroom is a toilet, hand-washing station, mirror, private storage, and shower. That does not require a private bath and does not forbid one. How many people actually share this bathroom is a tour question.
Rooms — every ALR. No more than two residents per sleeping room (older homes may have a grandfathered exception).
Not a capacity split: administrator qualifications; sprinklers (the home must disclose yes or no — Chapter 7 has no bed-count sprinkler mandate); awake staff 24 hours (a disclosure, required in a secure environment); a nurse on site (disclosure, not a size rule); owner living on site (not required); memory care (optional Part 25).
License-application fee bands also change with bed count. Those are operator fees. This page does not translate them into “a campus costs families more.”
Practical questions (not a ranking)
Ask this building. Tie the answers to the same Chapter 7 papers any ALR already owes you.
Who cooks, and when?
- Who plans menus, and who actually cooks on weekdays, evenings, weekends, and holidays?
- Staff of this building, a contracted cook, or someone else?
- May I see this week’s menu (posted at least 24 hours ahead) and the kitchen / pantry?
- Three meals, substitutes, and snacks? Who prepares a therapeutic diet if one is prescribed?
- Can residents help with meal prep or use the kitchen?
Neither “house kitchen” nor “commercial kitchen” is automatically better. Get cooking and special-diet charges on the 11.6 list.
Who is in charge at night and on weekends?
- Who is the administrator, and who is the qualified designee tonight and on Saturday?
- May I have the posted name and contact?
- If this home is licensed for more than 12 beds and the designee is in charge, who is the other on-duty caregiver?
- What does the 11.7(C) disclosure say about night and weekend staffing and whether anyone licensed or certified is on site?
- Are staff awake at night, and what do they do? (A tour question — not a Chapter 7 “always awake” rule unless this is a Part 25 secure environment.)
Keep the titles straight. The owner is not required to live here. The 8.7 CPR person on site is not the same as the administrator’s designee.
Shared baths vs private
- Is the bathroom private or shared? How many people share it?
- How is privacy handled for bathing and toileting?
Shared baths do not mean a worse home. Private baths do not mean a campus. The rule is one full bath per six residents, in every ALR.
Backup staff when someone calls out
- What happens at 6 a.m. or on a Sunday if the scheduled caregiver calls out?
- Who is the second person on the call list? How long until they arrive?
- May I see the 11.7(C) minimum-staffing disclosure, then compare it with an evening or weekend visit?
This page does not invent a Colorado small-home staffing ratio, an “owner must live here” rule, or a campus float-pool requirement.
Nurse on site
- 11.7(C) requires the home to tell you how much licensed or certified clinical staff is on site.
- Is a nurse employed here, contracted, on call, or not on staff? Which hours?
- What does a QMAP do vs what waits for a nurse?
A nurse on site is not a size rule.
Who leads activities? Use the 19 / 20–49 / 50+ table above, then ask who is actually responsible here, whether there is a written schedule, and whether posted offerings happen when listed.
Tour more than once. Make one visit unannounced, or stay for a meal. Take the packet home.
Cost is not a small-vs-campus number
Do not expect a government page that says a small house is cheaper or more expensive than a campus. That difference is unverified.
Get this home’s written resident agreement. 11.6(C) is the legal hook: services included in the rate and every optional service with a specified charge.
CareScout’s 2025 Cost of Care Survey counted both small group homes and large multi-service communities as assisted living. Surveyors collected private-pay monthly rates for a one-bedroom. There is one assisted-living median, not a small-house median and a campus median. Those mixed medians (labeled as medians of provider-reported rates, not a quote) were national $6,200 / month, Colorado $6,584 / month, and the Grand Junction survey region $6,400 / month (Clifton, Grand Junction, Fruita, and Palisade map to that region). They are not evidence that one building type costs more. CareScout itself says any particular provider may differ significantly from the median.
There is no official memory-care median on that survey either.
Mesa County: we cannot count small vs campus
The official August 27, 2026 Find and Compare export has 27 Active Mesa County ALRs. Columns are address, Facility ID, name, phone, type, status, and payor source.
There is no capacity field. There is no “small house” / “campus” field. There is no licensed-bed count.
This page does not write “most Mesa homes are small houses,” and it does not count campuses from marketing names (Lodge, Commons, Cappella, Villa, and the like). Those are names, not CDPHE capacity labels.
If a family wants to know how many people a home is licensed for, ask the home and/or CDPHE. It is not on that export.
Look the license up yourself on Find and Compare before you tour.
Official pages this guide used
- 6 CCR 1011-1 Chapter 7
- CDPHE Find and Compare Facilities
- CDPHE Assisted Living Residences
- CareScout Cost of Care (one assisted-living median; small homes and large communities mixed)
This page does not invent a small-vs-campus ranking, a cost difference, or a Mesa size count. It is not a recommendation.