Bring the water to a boil in a large pot; add the tapioca pearls and cook until translucent, 25 to 30 minutes. Stir the sugar and coconut into the tapioca and return the mixture to a boil; remove immediately from heat. Divide into 4 small bowls.
Stir the coconut cream and salt together in a small saucepan over medium-lot heat; cook until warm but do not boil, 5 to 10 minutes. Remove from heat. Spoon 1 to 2 tablespoons of the mixture over each serving of the tapioca pudding.