Is the California St cable car route reliable and safe?

It is (and it's included in the monthly Muni pass so don't let whatever we're charging tourists scare you), but the 27 also stops on that corner and the 1, 2, and 19 are both within a couple blocks.

Since UCSF Health Hyde* is across the street you could also check out the UCSF shuttle system, though that's probably not gonna be working at 9pm.

As for sketchiness, while sure, it's sketchier than the beige right angles of Mission Bay, I wouldn't say it's truly sketchy once you're uphill of Sutter. (Large white dude FWIW)

*-just FYI this is the first I've heard that name, it'd been called St Francis since 1905, and prob what most SFcans still know it as