Employee wants to use PTO and it is not showing up in my optional "Pay Items" even though it is set up correctly in her profile
It's good to see your post here, rachel36.
You'll probably want to make sure the Paid time off option is included when running your payroll. Since you've already set it in your employees profile, you will need to check this option from your Run payroll window.
Below are the instructions on how to do it:
Go to Workers and choose Employees.
Click Run payroll.
Choose a pay schedule and click Continue.
Click the Gear icon from the Run Payroll window and check the box for Paid time off.