But a new housing option has become available for families trying to leave behind a life on the streets.
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State funds have helped pay for several new shelters where the homeless not only have a place to stay, but also access to mental health and substance abuse treatment.
The latest Fresno shelter at the former Hacienda hotel is unique in that it allows families to live together and even keep their pets.
The Fresno HOME project aims to ease the transition to permanent housing.
Along Sinatra Street, there is someone to watch over the needy at the Hacienda complex.
Mental Health Services has opened 50 newly renovated rooms.
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Bernard Pitts used to be homeless. He's told many friends about this shelter.
"I see them now, the ones that are here, and their attitudes are totally different. They dress differently. They talk differently. It amazed me because a lot of them used to do drugs."
Sobriety is not a requirement at the low-barrier shelter. For 90 days, it offers residents access to substance abuse and mental health services as well as three meals a day.
"For a lot of business owners and residents that complain and call us because they see the homeless out in their neighborhood, this provides an opportunity for folks to come and get the essential services," says Fresno City Councilmember Esmeralda Soria.
The Hacienda campus provides several types of housing and treatment programs to help the homeless transition to a permanent living space.
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The collaborative approach has led other cities to take a closer look at how Fresno provides services to the homeless and their children.
"I think we're becoming in Fresno a national model for what you can do when a community and all the partners come together," says Mental Health Systems CEO Jim Callaghan.
The Fresno HOME program opened in July.
It didn't take long for all 50 rooms to fill up. Residents can stay for 90 days.