1) Install the plugin in both the production and dev environment
2) Select the environment after activation by clicking the "Local Sync Settings" in the left Nav bar.
3) Once the environment is selected, go to the live site (WP Admin Dashboard -> Local Sync Settings) and copy the connection string.
4) Paste that on the local environment to do the first pull. You can also select to exclude image files being downloaded.
5) Now your environment is ready to do the first sync. By clicking "Pull from Prod site" the site is cloned from the production site. By clicking "Push to prod site" the site changes made here are pushed to the live site.
6) You can exclude files or tables in both live and production environment by using the settings.