Actually, the responsibility for giving medication correctly lies with the medication assistant.......as long as s/he has been properly trained and/or delegated by an RN.
No, they usually don't have licenses or certifications that can be revoked, but it's really hard for them to find another job in AL if they have a history of med errors or diversion. Believe me, the management and staff at these places talk to people at other facilities all the time, and everybody knows each other's business only slightly better than they know their own.
I can relate to the OP's nervousness about unlicensed staff administering meds, because it scared the hell out of me when I was new to this area of nursing. I'm the DNS for a fairly large ALF in Oregon, where very few med aides or resident assistants are certified even as nurses' aides; training programs are short and informal, but relatively intense (if they're done right). I personally have rarely given meds in AL, except when I've worked a floor shift due to short staffing; the RN's role is more managerial/administrative than anything else in this environment.
The key to a safe and effective medication system in AL is knowing how and when to delegate, choosing good staff, and providing ongoing training and supervision. My own medication assistants do a better job than many of the CMAs and even nurses I've worked with in the past; they are consistent about their documentation, they know their stuff, and they can find their way around a nursing drug book when they don't know what a med is or what it does. They also know that they must ask questions and continue to learn, because no one (not even the nurse!) ever gets it all wired.
This is still a relatively young area of nursing, and the RN's role has evolved a great deal in just the 11 years since I started my first ALF job. Back then, I don't think anyone truly realized how critical proper delegation was; even the state surveyors were more concerned with the appearance and the food than they were with the medical piece. Now, we are more tightly regulated, and nursing has an enormous responsibility for the well-being of the residents. But it's still exciting and ever-changing, and the autonomy is wonderful---especially for those nurses who know their craft, don't need a lot of supervision, and have a knack for staff development.
Good luck, and let us know how it goes.