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However, in recent months, the city's clean-up efforts have started to pay off -- but as the mayor has said, it's going to take a lot more resources and time.
Despite what President Trump says about San Francisco, the city has demonstrated it's trying to take care of its homeless population.
Still, Supervisor Matt Haney of the Tenderloin district says he's not ready to pat himself on the back.
"The questions is, for us is, 'how hard can we work and fight for more solutions so that people really do see a difference on out streets?'" Haney said.
The city has lots of places that resemble an oasis -- like Flora Grubb, a peaceful and tranquil garden place in San Francisco's Bayview district -- but outside those structures, we often see the unpredictability of a neighborhood.
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If you drive down Jerrold Avenue, the same block as Flora Grubb Gardens, a section of that street is lined up with RVs and people living in their cars -- like Rick Britton who's been living there for the past five months.
"It's been really cold and wet and we don't have clothes," said Britton.
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There's no shame when rummaging for food among the piles of garbage and nothing seems to be done about the human waste seeping down the drains.
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The long line of tents seems to disappear along the railroad tracks.
"It gives them some kind of direction for them to know they're somewhere to be instead of being nowhere," said a woman who told us she hangs out there.
The city and non-profits like Glide have staff trying to reach out to people who need services, but not everyone accepts the help.
Chris Cook has been living in this van for nearly a year.
"If someone came up and said hey you want permanent housing, move in today," Cook said. "You would have to be, if you say no, you'd probably go to a looney bin or something."
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Even in these moments of despair, Rick Britton says he still holds onto hope.
"We have too much money in San Francisco and too many resources. They just need to come up with a better conclusion and with our mayor, I think she'll do it," he added.
RELATED: San Francisco opens first RV lot for homeless
The city estimates there are 313 RVs and 119 cars in the city that are home to individuals and families.
The homeless crisis does not recognize the holidays, and part of building a better Bay Area is exposing things that don't necessarily make us happy.
Take a look at all of ABC7's Building a Better Bay Area stories and videos.