Aspen Leaf Assisted Living-Limon Circle Co

A revisit survey was completed on 1/21/26 for all previous deficiencies cited on 9/16/25. The facility is in compliance with all deficiencies that were cited. Citation coded "0000" or "9999" are initial and final comments of an inspection for informational purposes, this field may also have been left blank intentionally

A recertification survey with complaint #CO40291 and #CO35793 was completed on 9/16/25. Deficiencies were cited. Based on observations and interviews, the facility (residence) failed to afford each member (resident) the opportunity to live and receive services in a safe environment, affecting 15 current residents.Findings Include:Observation on 9/16/25 at 8:05 a.m. revealed large water stains and damage on the ceiling of the dining and sitting areas.Observation on 9/16/25 at 8:30 a.m. revealed water damage above the bed of Confidential Resident #4 (CR#4).Observation on 9/16/25 at 4:20 p.m. revealed CR#4 lying at the foot of their bed to avoid the damaged ceiling area.Interview on 9/16/25 at 8:35 a.m. with CR#4 stated that the ceiling damage had been present for approximately four years witho.. Based on observations and interviews, the facility (residence) failed to comply with the Colorado Clean Indoor Air Act (CCIAA), affecting 15 current members (residents).Findings Include:Observations on 9/16/25 at 7:35 a.m. and 8:18 a.m. revealed three residents smoking less than 15 feet from the residence entryway.Interview on 9/16/25 at 7:35 a.m. with Resident #2 stated she knew the area was not compliant with code requirements.Interview on 9/16/25 at 4:30 p.m. with the administrator confirmed the designated smoking area was less than 15 feet from the entryway and acknowledged it violated the Act. Based on observations and interviews, the facility (residence) failed to ensure medications were administered in accordance with 6 C.C.R 1011-1, Chapter VII, for 15 current members (residents).Findings include:Chapter 7 regulations governing assisted living residences, part 14.10(H), requires that, unless otherwise allowed by statute, the assisted living residence shall not permit a qualified medication administration person to perform pre-pouring of medication.Observation on 9/16/25 at 7:00 a.m. revealed the QMAP pushing an open cart containing residents ' medications.Observation on 9/16/25 at 9:59 a.m. of the medication storage room revealed an unmarked souff.. Based on observations, records review, and interviews, the facility (residence) failed to ensure the setting is physically accessible to all members (residents) for one (#1) of the three sample residents.Findings Include:Observation on 9/16/25 at 8:35 a.m. revealed Resident #1 transferring from a patio chair into her electric wheelchair positioned beside the sliding door, as she could not access the patio directly in her wheelchair.Record review of Resident #1 ' s care plan dated 6/23/25 noted the resident required a brace for ambulation, and that the resident refused to wear the brace.Interview on 9/16/25 at 8:35 a.m. with Resident #1 stated she was told upon admission eight years ago tha.. Based on records review and interviews, the facility (residence) failed to honor a members (resident ' s) right to freely choose healthcare services by not assisting with emergency medical services (EMS) when requested, affecting one (#2) of three sampled residents.Findings Include:Record review of an 8/17/25 progress note documented that Resident #2 fell, hit her head, and requested EMS. Staff notified on-call but did not assist with EMS. A bruise was later observed.Record review of an 8/5/25 progress note documented that Resident #2 requested EMS for severe constipation. Staff offered prune juice and scheduled urgent care instead. Resident #2 called EMS herself and was tra..

A relicensure survey with complaint #CO40289 and #CO35791 was completed on 9/16/25. Deficiencies were cited. Based on observation and interviews, the residence failed to maintain a physically safe and sanitary environment by not addressing water damage in common and resident areas, affecting 15 current residents.Findings Include:Observation on 9/16/25 at 8:05 a.m. revealed large water stains and damage on the ceiling of the dining and sitting areas.Observation on 9/16/25 at 8:30 a.m. revealed water damage above the bed of Confidential Resident #4 (CR#4).Observation on 9/16/25 at 4:20 p.m. revealed CR#4 lying at the foot of their bed to avoid the damaged ceilin.. Based on observations and interviews, the residence failed to comply with the Colorado Clean Indoor Air Act (CCIAA) by permitting smoking within 15 feet of the residence entryway, affecting 15 current residents.Findings Include:Observations on 9/16/25 at 7:35 a.m. and 8:18 a.m. revealed three residents smoking less than 15 feet from the residence entryway.Interview on 9/16/25 at 7:35 a.m. with Resident #2 stated she knew the area was not compliant with code requirements.Interview on 9/16/25 at 4:30 p.m. with the administrator confirmed the designat.. Based on observations and interviews, the residence failed to prohibit pre-pouring of medications by qualified medication administration persons (QMAPs), affecting 15 current residents.Findings Include:Observation on 9/16/25 at 7:00 a.m. revealed the QMAP pushing an open cart containing residents ' medications.Observation on 9/16/25 at 9:59 a.m. of the medication storage room revealed an unmarked soufflé cup with unknown powder on the open cart, along with 12 other marked medications for other residents.Interview on 9/16/25 at 9:50 a.m. with Staff #3 sta.. Based on observations, record review, and interviews, the residence failed to ensure all common areas were accessible to residents using an electric wheelcBased on records review and interviews, the residence failed to honor a resident ' s right to freely choose healthcare services by not assisting with emergency medical services (EMS) when requested, affecting one (#2) of three sampled residents.Findings Include:Observation on 9/16/25 at 8:35 a.m. revealed Resident #1 transferring from a patio chair into her electric wheelchair positioned beside the sliding door, a.. Based on records review and interviews, the residence failed to honor a resident ' s right to freely choose healthcare services by not assisting with emergency medical services (EMS) when requested, affecting one (#2) of three sampled residents.Findings Include:Record review of an 8/17/25 progress note documented that Resident #2 fell, hit her head, and requested EMS. Staff notified on-call but did not assist with EMS. A bruise was later observed.Record review of an 8/5/25 progress note documented that Resident #2 requested EMS for severe constipation. Staff offered prune juice .. THIS PORTION OF THE REPORT IS FOR INFORMATIONAL PURPOSES ONLY. No response is necessary. The residence was advised that it must review and maintain the following processes in accordance with existing program regulations found at 6 CCR 1011-1, Chapter 7.21.1 The assisted living residence grounds shall be kept free of high weeds, garbage, and rubbish.24.4 All garbage and rubbish that is not disposed of as sewage shall be collected in impervious containers in such manner as not to become a nuisance or a health hazard and shall be removed to an out..