Depends on the age of the client and degree of the horrible condition. If it was a minor the odds are I would make a report to CPS. If the client is elderly and unable to care for themselves well enough, I would make an APS report and utilize community resources and/or family to help the situation. If the client is an capable adult, I could offer community resources and ask permission to talk to other family member, but this scenario has much less options because as an adult he has the right to refuse help. In California, the city can close the property if there is no running water. But, it is better to try to improve the living condition rather than making them homeless. This is a very short answer to a complicated question.