"Fecal matter causes a health and safety issue and people work down here, so we have to walk through it," said Dalila Flintroy, who works in downtown.
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And sanitation worries go beyond the tent sites. An AIR7HD tour on Monday revealed trash heaps overflowing sidewalks on to San Pedro Street, just south of downtown.
"There's chairs, there's furniture, there's mattresses, and in some cases, blocking entire streets," said helicopter reporter Scott Reiff.
Outcry is rising and the sanitation department is scrambling. On Monday, several streets and sidewalks on Skid Row were power washed.
For the last 10 years, the courts have allowed people to dwell with their possessions in tents because there are not enough shelters to house them. To control rats and disease, regular clean ups are scheduled after giving the tent dwellers 24 hours notice.
"I know a lot of people think we should have snapped our fingers and it should be done with," said Mayor Eric Garcetti in response to questions on Monday.
The mayor said the city is already housing three times as many people as it did three years ago. Because of multiple social and economic factors, he said the number of people in need will continue to grow and not just in Southern California.
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"I don't release people from the prisons. I can't cure somebody from an opioid addiction. I need help. We need help from our federal government," Garcetti said.
Residents see a confluence of sky-high rents and untreated mental-health conditions.
People using the street as a toilet? ABC7 saw it happen at a high-end part of downtown on Monday. People in the area say it happens all the time because there are no public toilets. The businesses don't want them.
The city said that citizens can combat illegal dumping by calling the Sanitation Department's hotline number (800) 773-2489.
Meantime, the mayor reports progress regarding transitional housing.
The Irmas Transitional Living Center was opened last week in North Hollywood. It is the first facility constructed with voter-approved HHH funds.
Additional facilities are in the pipeline to house 7,000 people.