If the file in the i386 folder shows as access.cpl and not access.cp_, copy
it to the Windows\system32\dllcache folder and if necessary to the
Windows\system32 folder as well.
Normally the Accessibility Options are not an optional component but there
is a tweak (editing an INF file) that can be used to uninstall it. If this
tweak has been used on this system, Accessibility Options should show up in
Add/Remove Programs> Add/Remove Windows Components. If it's there, you
could try placing a check in the box and clicking OK to see if it will
install.