04/06/2020- OTHER HEALTH- GLEN AT LAKE OCONEE VILLAGE, THEPRINTED: 4/8/2020
FORM APPROVED State of GA, Healthcare Facility Regulation Division
State of GA Inspection Report
STATE FORM 6899 XKAA11 If continuation sheet Page 1 of 1
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
ALC000233
(X2) MULTIPLE CONSTRUCTION
A.BUILDING
B.WING
(X3) DATE SURVEY
COMPLETED
04/06/2020
NAME OF PROVIDER OR SUPPLIER
GLEN AT LAKE OCONEE VILLAGE, THE
STREET ADDRESS, CITY, STATE, ZIP CODE
1070 OLD SALEM ROAD
GREENSBORO, GA 30642
(X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES
(EACH DEFICIENCY MUST BE PRECEDED BY FULL
REGULATORY OR LSC IDENTIFYING INFORMATION)
{L 0000}
>>>> The purpose of this review is to monitor COVID 19 cases and assess infection control
processes.