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7/12/2019 - COMPLAINT HEALTH SURVEY - GLEN AT LAKE OCONEE VILLAGE, THEPRINTED: 10/15/2019 FORM APPROVED State of GA, Healthcare Facility Regulation Division State of GA Inspection Report STATE FORM 6899 0NRN11 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 07/12/2019 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 000} Initial Comments. >>>>The purpose of this visit was to investigate #GA00197741. No violations were cited as a result of this inspection. An onsite visit was made on 7/10/19 and the investigation was completed on 7/12/19. .