In a chaotic scene, people hid in bathrooms at the Eye Medical Clinic and were seen climbing from the windows of the ground level building as police arrived.
Officers heard one gunshot as they arrived, Fresno police Lt. Joe Gomez said. To help people inside the building get out, police smashed windows and helped people climb to safety, Gomez said.
Fresno Deputy Police Chief Pat Farmer said there are two businesses in the building - a pediatric clinic and an eye clinic. There were 16 employees and patients inside both businesses.
"Several people were running out of the building frantically," Farmer said.
No other injuries were reported, Gomez said. Investigators found a shotgun inside the clinic, Gomez said.
Gomez identified the shooter as 43-year-old Neng Moua of Clovis.
The victim is a 33-year-old woman, but her name was not released. Farmer said the woman was shot multiple times at close range.
The exact nature of their current relationship was not immediately clear.
Fresno Deputy Police Chief Pat Farmer said the couple did not live together but have five children together.
The woman also had two other children.
The ages of the children were not released. They are all fine.
Russ Spidston, Moua's neighbor, said he was a hardworking roofer who was friendly and outgoing and who would have parties his children attended.
"To find out what he did, it just doesn't meet his character," Spidson said, adding that he never saw or heard any problems.
A motive in the murder-suicide was not immediately known but a custody dispute could have sparked the shooting, Farmer said. He said police had one prior domestic dispute contact with Neng 11 years ago.
On Tuesday, the call came in as a domestic disturbance shortly before 11 a.m., police said. Police said officers surrounded the building and ordered people to evacuate.
Believing they had an active shooter on the loose, police called in SWAT members who entered the building. They heard a woman with three children, call out and told her to stay put.
Another woman, Raquel Castillo, a 31-year-old caregiver said she heard shots while inside with a patient visiting the clinic.
"I heard him shoot three times and I heard people screaming," Castillo said.
A short search of the building led to the bodies.
Several nearby businesses and Fresno City Hall were evacuated during the search, but people have since returned to those buildings.
"This is a tragedy and we are grateful no one else was hurt during this incident," Farmer said.
The Marjaree Mason Center issued the following statement in response to the incident that occurred in Downtown Fresno today, March 31, 2015:
The Marjaree Mason Center was established in the name of Marjaree Mason, whose life was tragically taken in a similar murder suicide incident. This is why we are here, and it's another reminder that domestic violence is absolutely a local issue to Fresno County. This severe abuse doesn't happen overnight; it can start with verbal abuse, escalate to physical abuse and unfortunately, as in this case, may result in death. If you or someone you know is exposed to domestic violence, please call the Marjaree Mason Center 24-hour confidential hotline at 559-233-HELP (4357).
Genelle Taylor Kumpe, Executive Director of the Marjaree Mason Center
The Associated Press contributed to this report.
Texts from a witness to her husband when gunmen went inside doctors officer. pic.twitter.com/RPbc7wB5qq— Veronica Miracle (@VeronicaABC30) March 31, 2015
#WITNESS: The office is a pediatric doctors office. Witness' wife saw gunmen shoot a woman who works at office 3 or 4 times.— Veronica Miracle (@VeronicaABC30) March 31, 2015
Witness' wife who works in office says gun was huge saw an office worker get shot in chest once. Witness' wife fears victim won't make it.— Veronica Miracle (@VeronicaABC30) March 31, 2015
Helicopter over head making announcements asking for anyone who's seen a man wearing a white overcoat to call 911. @ABC30— Veronica Miracle (@VeronicaABC30) March 31, 2015