The official social services watchdog has criticised the HSE for failing to comply with child protection standards in counties Carlow and Kilkenny.
Inspectors found that HSE personnel had failed to consistently notify gardaí about abuse issues as required by law.
They also expressed concern about inaccurate and out-of-date records of children at risk.
It is the first report of its kind by the Health Information and Quality Authority and follows a series of pre-announced visits by inspectors to the Carlow-Kilkenny Child Protection and Welfare Services.
Overall, it says that services to children were safe and that many of them and members of their families who agreed to be interviewed rated them positively.
However, contrary to recently-strengthened child protection laws, there was ineffective management of both waiting lists for assessments and the allocation of social workers to cases of children at risk.
The inspectors also found there was a possibility that high-priority cases might not receive the attention they needed.
The HSE has supplied a 20-page response detailing how it is working to address the issues highlighted. It is included in the HIQA report.
Minister for Children and Youth Affairs Frances Fitzgerald welcomed the report.
Speaking on RTÉ's News at One, Ms Fitzgerald said that on entering office she had been concerned at the lack of objective inspections into child protection services.
She said she had already responded to the report, and that it had clearly identified areas where improvements needed to be made.
"Of course I am not satisfied (with the findings), but what I am satisfied with is that for the first time we're having the inspection, we're having an objective assessment," she said.
"Clearly there is work to be done and the HSE has responded and has a plan to address the issues that were outlined," she added.