They are to scale, sometime a fix or a beacon may be at the wrong location because of the sheet size but it's always mentionned.
As example on the following chart, the Creil vortac is located at a wrong position but we can read "NOT TO SCALE".
Also for the vor CAN, as it is outside the sheet, the line leading to it is ended by /\/\/\/ to show us it's not to scale.
However, to calibrate my map images, I only trusted the original grid coordinates.
Stéphane