HIQA says allegations of child abuse made to the Child and Family Agency in the Midlands are not always reported to Gardaí.
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The body has released a report into TULSA which raises serious concerns about its services.
The health watchdog says 22 children were removed from their homes by Gardaí as a result of its work earlier this year.
HIQA carried out a nine day inspection of TULSA's operation across Laois Offaly Westmeath and Longford and has highlighted significant risks in a number of areas.
TUSLA says it welcomes the report – saying the inspections allow the organisation ensure services are continuously improved.
