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The political sociology of homelessness is undertheorized; few attempts have been made to explain the forms local homeless governance takes. This paper addresses this gap by analyzing the role of service orientations—a topic extensively treated in sociology—in the development of subnational policies to address homelessness in San Diego, California. Through document review and interviews, I show that the city’s development of two program areas was shaped by state and federal guidelines related to the service orientations of criminalization, containment, and care. National best practices eschew criminalization but tolerate containment and require local governments to show how they extend care services, through a commitment to a housing first ethos. These pressures informed how San Diego staff positioned their work. However, the local context of unaffordable housing and low vacancy makes a true housing first approach almost non-existent in the city and the result is that city programs use care services within the context of criminalization and containment. Absent housing, city staff’s inability to provide people experiencing homelessness with true housing choice or service autonomy is masked by the language of care, which ultimately serves to attenuate the politically and socially problematic nature of criminalization and containment.