At any time, anyone with access to a payment terminal who knew where to look could process transactions manually from these records. They could have double charged and skimmed, done reversals for a cut, or copied and sold customer profiles with CC numbers. These were BSA products marketed to small and medium sized businesses, so no one questioned compliance.
That said, on the flip side, because of things like "Dual Control" the PCI DSS is physically impossible for some small companies to abide by. In the past we dealt with credit cards and had a few audits, and they admitted that many of the points are aimed at companies that don't consist of just two people.
Also, look at it from their POV. In a normal course of business a lot of these mom and pops probably already are storing credit card information on paper and/or in word documents. So you're saying the system you build for them is going to be, in some ways, less useful than their current ad-hoc system.
My mom & pop tax guy emails me my tax return as an encrypted pdf, with the password being... the last 4 digits of my SSN.
On the flip side though, to some extent, I would consider these records safer than a website. At least to gain access to these records you would have to physically enter the building, climb in the attic, sift through hundreds of boxes, gather the info you want, and then leave. This would also require you be in the general location of the building and have knowledge of the records being there. Hacking a website database from across the globe is a whole lot easier, so you I would say that their existing paper system is more secure to a degree.
For example, about two years ago I had a property management company ask me to build out a site to handle rent payments for them. They wanted to store and have access to the full credit card numbers to manually process transactions for failed or late payments. When I told them they were not allowed to do that they terminated the contract with me. I know they went on to hire a developer to build out a site for them and store credit card numbers. While I don't know if they are still doing it, it did happen for an extensive period of time.